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Cheng JJ, Liang LJ, Lee CC. Associations of appendicular lean mass and abdominal adiposity with insulin resistance in older adults: A cross-sectional study. PLoS One 2024; 19:e0303874. [PMID: 38753649 PMCID: PMC11098336 DOI: 10.1371/journal.pone.0303874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/01/2024] [Indexed: 05/18/2024] Open
Abstract
Loss of lean muscle mass and accumulation of adipose tissue are changes associated with aging. Previous studies have documented various components of body composition as predictors for insulin resistance. The objective of this study was to investigate whether components of body composition-appendicular lean mass (ALM) and/or abdominal fat mass (AFM)-correlate with insulin resistance in older men and women. This was a cross-sectional study of 92 older men and women. Weight was classified according to body mass index (BMI)-normal (BMI <25), overweight (BMI 25-30), and obese (BMI >30). All body composition data was determined by dual energy x-ray absorptiometry (DEXA), and insulin resistance was assessed by the homeostatic model assessment of insulin resistance (HOMA-IR). Multivariable regression models with two-way interaction terms were employed to assess whether the associations between components of body composition and log HOMA varied by BMI categories. Adjusted regression showed that log HOMA was significantly associated with AFM (estimate ± standard error: 0.055 ± 0.026) and ALM (0.057 ± 0.029) for the overweight participants (p-values <0.05). Additionally, the adjusted associations between log HOMA and ALM were significantly greater for participants who were either obese or overweight compared to those with a normal BMI (p<0.002). Less consistent relationships were observed between insulin resistance and abdominal fat mass across BMI categories, whereas more consistent associations were observed between insulin resistance and appendicular lean mass in individuals with greater BMI. Further research is needed to clarify if lipid deposition within muscle tissue promotes muscle dysfunction and thereby increases risk for insulin resistance.
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Affiliation(s)
- Justin J. Cheng
- Geriatric Research Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, United States of America
| | - Li-Jung Liang
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
| | - Cathy C. Lee
- Geriatric Research Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, United States of America
- David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
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Rodrigues PS, Mendonça FM, Neves JS, Luís C, Rodrigues I, Moreno T, Festas D, Pedro J, Varela A, Fernandes A, Costa EL, Freitas P. Effects of Bariatric Surgery on Sarcopenic Obesity Outcomes: A One-Year Prospective Study in Middle-Aged Women. Obes Surg 2024; 34:1674-1683. [PMID: 38523172 DOI: 10.1007/s11695-024-07164-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION Sarcopenic obesity (SO) is characterised by the confluence of muscle deterioration and high adiposity. When non-surgical interventions prove insufficient, bariatric surgery (BS) becomes the primary approach. This study aimed to address BS effects on SO outcomes 1 year post-surgery among middle-aged women, also considering physical exercise's impact. METHODS Prospective single-centre study of 140 patients who underwent Roux-en-Y gastric bypass or sleeve gastrectomy between November 2019 and December 2022. Participants were categorised into tertiles according to SO's diagnosis and severity (group 1-patients with the most severe SO; group 2-intermediate; group 3-the least severe or without SO), calculated considering the consensus issued by ESPEN and EASO in 2022. Evaluations of clinical and biochemical parameters were conducted before and 12 months after BS, and the variation was used for comparative purposes. Body composition was assessed using bone density scans. Linear regression analysis accounted for both surgery type and baseline body mass index (BMI). RESULTS Before BS, SO prevalence in the overall sample was 89.3%, decreasing to 2.9% after BS. Group 1 had more body fat mass (56.9 vs 54.8 vs 50.7 kg, p < 0.001), total, trunk and leg fat at baseline and a significantly lower total skeletal muscle mass (47.2 vs 49.4 vs 51.8 kg, p < 0.001). One year post-BS, group 1 presented more weight loss (- 39.8 ± 11.4 kg, p = 0.031), BMI reduction (- 15.9 ± 4.6 kg/m2, p = 0.005) and lost more fat mass (- 32.6 vs - 30.5 vs - 27.9 kg, p = 0.005), but not total skeletal muscle mass (- 5.8 vs - 5.9 vs - 6.8 kg, p = 0.130). Remission rates for comorbidities were substantial among all groups, but more marked among patients within group 1 (type 2 diabetes mellitus 75%, hypertension 47.1% and dyslipidemia 52.8%). Engagement in physical exercise of any kind has increased post-BS (33.1% vs 79.1%). CONCLUSION Despite concerns about malabsorptive mechanisms potentially worsening muscle loss, patients with the most severe SO undergoing BS lost more fat mass while experiencing the smallest reduction in total skeletal muscle mass. Remission rates for comorbidities following BS were notable among all groups.
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Affiliation(s)
- Pietra S Rodrigues
- Biochemistry Unit, Biomedicine Department, FMUP-Faculty of Medicine, University of Porto, 4200-450, Porto, Portugal
| | - Fernando M Mendonça
- Endocrinology, Diabetes and Metabolism Service, São João Hospital and University Centre, 4200-319, Porto, Portugal.
- CRIO group (Centro de Responsabilidade Integrada de Obesidade), São João Hospital and University Centre, 4200-319, Porto, Portugal.
| | - João S Neves
- Endocrinology, Diabetes and Metabolism Service, São João Hospital and University Centre, 4200-319, Porto, Portugal
- Cardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Carla Luís
- Biochemistry Unit, Biomedicine Department, FMUP-Faculty of Medicine, University of Porto, 4200-450, Porto, Portugal
- i3S (Instituto de Investigação e Inovação em Saúde), Universidade do Porto, 4200-135, Porto, Portugal
| | - Ilda Rodrigues
- Biochemistry Unit, Biomedicine Department, FMUP-Faculty of Medicine, University of Porto, 4200-450, Porto, Portugal
| | - Telma Moreno
- Endocrinology, Diabetes and Metabolism Service, São João Hospital and University Centre, 4200-319, Porto, Portugal
| | - Diana Festas
- Endocrinology, Diabetes and Metabolism Service, São João Hospital and University Centre, 4200-319, Porto, Portugal
- CRIO group (Centro de Responsabilidade Integrada de Obesidade), São João Hospital and University Centre, 4200-319, Porto, Portugal
| | - Jorge Pedro
- Endocrinology, Diabetes and Metabolism Service, São João Hospital and University Centre, 4200-319, Porto, Portugal
- CRIO group (Centro de Responsabilidade Integrada de Obesidade), São João Hospital and University Centre, 4200-319, Porto, Portugal
| | - Ana Varela
- Endocrinology, Diabetes and Metabolism Service, São João Hospital and University Centre, 4200-319, Porto, Portugal
- CRIO group (Centro de Responsabilidade Integrada de Obesidade), São João Hospital and University Centre, 4200-319, Porto, Portugal
| | - Ana Fernandes
- Nuclear Medicine Department, São João Hospital and University Centre, 4200-319, Porto, Portugal
- CINTESIS.UFP@RISE (Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde), Universidade Fernando Pessoa, 4249-004, Porto, Portugal
| | - Eduardo L Costa
- CRIO group (Centro de Responsabilidade Integrada de Obesidade), São João Hospital and University Centre, 4200-319, Porto, Portugal
| | - Paula Freitas
- CRIO group (Centro de Responsabilidade Integrada de Obesidade), São João Hospital and University Centre, 4200-319, Porto, Portugal
- i3S (Instituto de Investigação e Inovação em Saúde), Universidade do Porto, 4200-135, Porto, Portugal
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De Vincentis S, Greco C, Fanelli F, Decaroli MC, Diazzi C, Mezzullo M, Milic J, De Santis MC, Roli L, Pagotto U, Guaraldi G, Rochira V. Sarcopenic obesity and reduced BMD in young men living with HIV: body composition and sex steroids interplay. J Endocrinol Invest 2024:10.1007/s40618-024-02375-6. [PMID: 38643322 DOI: 10.1007/s40618-024-02375-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/09/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE Sex steroids play a key role on male bone homeostasis and body composition (BC), their role in men living with HIV (MLWH) is less recognized. This study aimed at investigating the prevalence of low BMD, sarcopenia, and sarcopenic obesity (SO) and their relationship with sex steroids in MLWH aged < 50. METHODS Prospective, cross-sectional, observational study on MLWH younger than 50 (median age 47.0 years). BC and BMD were evaluated with DXA. Two different definitions of sarcopenia were applied: appendicular lean mass/height2 (ALMI) < 7.26 kg/m2 or appendicular lean mass/body weight (ALM/W) < 28.27%. Low BMD was defined for Z-score < -2.0. Sarcopenia coupled with obesity identified SO. Serum total testosterone (T) and estradiol (E2) were measured by LC-MS/MS; free testosterone (cFT) was calculated by Vermeulen equation. RESULTS Sarcopenia was detected in 107 (34.9%) and 44 (14.3%) out of 307 MLWH according to ALMI and ALM/W, respectively. The prevalence of SO was similar by using both ALMI (11.4%) and ALM/W (12.4%). Sarcopenic and SO MLWH had lower total T and cFT in both the definition for sarcopenia. BMD was reduced in 43/307 (14.0%). Serum E2 < 18 pg/mL was an independent contributing factor for sarcopenia, SO, and low BMD. CONCLUSIONS T and E2 are important determinants of BC even in MLWH. This is among the first studies investigating the distribution of obesity phenotypes and the prevalence of SO among MLWH showing that SO is present in 11-12% of enrolled MLWH regardless of the definition used. However, deep differences emerged using two different diagnostic definitions.
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Affiliation(s)
- S De Vincentis
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini, 1355, 41126, Modena, Italy.
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy.
| | - C Greco
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini, 1355, 41126, Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - F Fanelli
- Endocrinology Research Group, Department of Medical and Surgical Sciences, Center for Applied Biomedical Research, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - M C Decaroli
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini, 1355, 41126, Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - C Diazzi
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - M Mezzullo
- Endocrinology Research Group, Department of Medical and Surgical Sciences, Center for Applied Biomedical Research, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - J Milic
- Multidisciplinary Metabolic Clinic, Unit of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - M C De Santis
- Department of Laboratory Medicine and Pathology, Azienda USL of Modena, Modena, Italy
| | - L Roli
- Department of Laboratory Medicine and Pathology, Azienda USL of Modena, Modena, Italy
| | - U Pagotto
- Endocrinology Research Group, Department of Medical and Surgical Sciences, Center for Applied Biomedical Research, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - G Guaraldi
- Multidisciplinary Metabolic Clinic, Unit of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - V Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini, 1355, 41126, Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
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Maïmoun L, Bourgeois E, Serrand C, Mura T, Cristol JP, Myzia J, Avignon A, Mariano-Goulart D, Sultan A. Relationship between Lean Tissue Mass and Muscle Function in Women with Obesity. Nutrients 2023; 15:4517. [PMID: 37960170 PMCID: PMC10649051 DOI: 10.3390/nu15214517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
It is well documented that lean tissue mass (LTM) decreases with aging in patients with obesity, but there is no information available regarding muscle strength changes, a parameter that may be better associated with sarcopenic obesity (SO). The objectives of this study were to analyze the changes in LTM and fat mass (FM), muscle strength and muscle function with aging in women with obesity and to determine the prevalence of SO. LTM and FM were determined by DXA, muscle strength with the hand-grip test and muscle function with the 6 min walk test (6MWT) in 383 women with obesity. A redistribution of the LTM and FM occurred with age, characterized by a gain at the trunk to the detriment of the lower limbs, thus reducting in appendicular LTM indices. The physical performances evaluated by the muscle strength and muscle function decreased concomitantly, and the prevalence of low values for both these parameters was 22.8% and 13.4%, respectively, in the older patients. In summary, although a reduction in appendicular LTM and muscle performances occurred with age and resulted in an increase in the prevalence of SO, the number of women with obesity affected by SO remained low (n ≤ 15), even in those older than 60 years.
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Affiliation(s)
- Laurent Maïmoun
- Depatment of Nuclear Medicine, CHU Montpellier, 34295 Montpellier, France;
- Physiology and Experimental Medicine of the Heart and Muscles (PhyMedExp), University of Montpellier, 34295 Montpellier, France; (E.B.); (J.-P.C.); (A.S.)
| | - Elise Bourgeois
- Physiology and Experimental Medicine of the Heart and Muscles (PhyMedExp), University of Montpellier, 34295 Montpellier, France; (E.B.); (J.-P.C.); (A.S.)
- Department of Endocrinology, Nutrition and Diabetes, Team Nutrition, Diabetes, CHU Montpellier, 34295 Montpellier, France;
| | - Chris Serrand
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology, CHU Nîmes, 30029 Nîmes, France; (C.S.); (T.M.)
| | - Thibault Mura
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology, CHU Nîmes, 30029 Nîmes, France; (C.S.); (T.M.)
| | - Jean-Paul Cristol
- Physiology and Experimental Medicine of the Heart and Muscles (PhyMedExp), University of Montpellier, 34295 Montpellier, France; (E.B.); (J.-P.C.); (A.S.)
- Departement of Biochimy, Chu Montpellier, 34295 Montpellier, France
| | - Justine Myzia
- Department of Clinical Physiology, CHU Montpellier, 34295 Montpellier, France;
| | - Antoine Avignon
- Department of Endocrinology, Nutrition and Diabetes, Team Nutrition, Diabetes, CHU Montpellier, 34295 Montpellier, France;
- Desbrest Institute of Epidemiology and Public Health, IDESP UMR UA11 INSERM, University of Montpellier, 34295 Montpellier, France
| | - Denis Mariano-Goulart
- Depatment of Nuclear Medicine, CHU Montpellier, 34295 Montpellier, France;
- Physiology and Experimental Medicine of the Heart and Muscles (PhyMedExp), University of Montpellier, 34295 Montpellier, France; (E.B.); (J.-P.C.); (A.S.)
| | - Ariane Sultan
- Physiology and Experimental Medicine of the Heart and Muscles (PhyMedExp), University of Montpellier, 34295 Montpellier, France; (E.B.); (J.-P.C.); (A.S.)
- Department of Endocrinology, Nutrition and Diabetes, Team Nutrition, Diabetes, CHU Montpellier, 34295 Montpellier, France;
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Axelrod CL, Dantas WS, Kirwan JP. Sarcopenic obesity: emerging mechanisms and therapeutic potential. Metabolism 2023:155639. [PMID: 37380015 DOI: 10.1016/j.metabol.2023.155639] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/08/2023] [Accepted: 06/17/2023] [Indexed: 06/30/2023]
Abstract
Sarcopenic obesity, or the loss of muscle mass and function associated with excess adiposity, is a largely untreatable medical condition associated with diminished quality of life and increased risk of mortality. To date, it remains somewhat paradoxical and mechanistically undefined as to why a subset of adults with obesity develop muscular decline, an anabolic stimulus generally associated with retention of lean mass. Here, we review evidence surrounding the definition, etiology, and treatment of sarcopenic obesity with an emphasis on emerging regulatory nodes with therapeutic potential. We review the available clinical evidence largely focused on diet, lifestyle, and behavioral interventions to improve quality of life in patients with sarcopenic obesity. Based upon available evidence, relieving consequences of energy burden such as oxidative stress, myosteatosis, and/or mitochondrial dysfunction is a promising area for therapeutic development in the treatment and management of sarcopenic obesity.
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Affiliation(s)
- Christopher L Axelrod
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Wagner S Dantas
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - John P Kirwan
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA.
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Sheptulina AF, Antyukh KY, Kiselev AR, Mitkovskaya NP, Drapkina OM. Possible Mechanisms Linking Obesity, Steroidogenesis, and Skeletal Muscle Dysfunction. Life (Basel) 2023; 13:1415. [PMID: 37374197 DOI: 10.3390/life13061415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Increasing evidence suggests that skeletal muscles may play a role in the pathogenesis of obesity and associated conditions due to their impact on insulin resistance and systemic inflammation. Skeletal muscles, as well as adipose tissue, are largely recognized as endocrine organs, producing biologically active substances, such as myokines and adipokines. They may have either beneficial or harmful effects on the organism and its functions, acting through the endocrine, paracrine, and autocrine pathways. Moreover, the collocation of adipose tissue and skeletal muscles, i.e., the amount of intramuscular, intermuscular, and visceral adipose depots, may be of major importance for metabolic health. Traditionally, the generalized and progressive loss of skeletal muscle mass and strength or physical function, named sarcopenia, has been thought to be associated with age. That is why most recently published papers are focused on the investigation of the effect of obesity on skeletal muscle function in older adults. However, accumulated data indicate that sarcopenia may arise in individuals with obesity at any age, so it seems important to clarify the possible mechanisms linking obesity and skeletal muscle dysfunction regardless of age. Since steroids, namely, glucocorticoids (GCs) and sex steroids, have a major impact on the amount and function of both adipose tissue and skeletal muscles, and are involved in the pathogenesis of obesity, in this review, we will also discuss the role of steroids in the interaction of these two metabolically active tissues in the course of obesity.
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Affiliation(s)
- Anna F Sheptulina
- Department of Fundamental and Applied Aspects of Obesity, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
- Department of Therapy and Preventive Medicine, A.I. Evdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia
| | - Karina Yu Antyukh
- Republican Scientific and Practical Center of Cardiology, 220036 Minsk, Belarus
| | - Anton R Kiselev
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
| | - Natalia P Mitkovskaya
- Republican Scientific and Practical Center of Cardiology, 220036 Minsk, Belarus
- Department of Cardiology and Internal Diseases, Belarusian State Medical University, 220116 Minsk, Belarus
| | - Oxana M Drapkina
- Department of Fundamental and Applied Aspects of Obesity, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
- Department of Therapy and Preventive Medicine, A.I. Evdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia
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Meys R, Machado FV, Spruit MA, Stoffels AA, van Hees HW, van den Borst B, Klijn PH, Burtin C, Pitta F, Franssen FM. Frequency and Functional Consequences of Low Appendicular Lean Mass and Sarcopenic Obesity in Patients with Asthma Referred for Pulmonary Rehabilitation. Obes Facts 2023; 16:435-446. [PMID: 37232056 PMCID: PMC10601668 DOI: 10.1159/000531196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 05/16/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION One of the most prominent extrapulmonary manifestations in patients with chronic respiratory disease is changes in body weight and composition. However, the frequency and functional consequences of low appendicular lean mass (ALM) or sarcopenic obesity (SO) in patients with asthma are largely unknown. Therefore, the aim of the current study was to assess the frequency and functional consequences of low appendicular lean mass index (ALMI) and SO in patients with asthma. METHODS A retrospectively analyzed cross-sectional study was conducted in 687 patients with asthma (60% female, 58 ± 13 years, FEV1 76 ± 25% pred) referred for comprehensive pulmonary rehabilitation (PR). Body composition, pulmonary function, exercise capacity, quadriceps muscle function, and quality of life were assessed. Patients were classified as presenting low ALMI according to the 10th percentiles of age-sex-body mass index (BMI)-specific reference values and as having SO according to the diagnostic procedure proposed by the 2022 ESPEN/EASO consensus. In addition, clinical outcomes between patients with normal and low ALMI or with and without SO were compared. RESULTS The frequency of patients classified as low ALMI was 19%, whereas 45% of the patients were obese. Among the obese patients, 29% had SO. In patients with normal weight, those with low ALMI were younger and had worse pulmonary function, exercise capacity and quadriceps muscle function than those with normal ALMI (all p < 0.05). Overweight patients with low ALMI presented poorer pulmonary function and quadriceps muscle function (both strength and total work capacity). In obese class I patients, those with low ALMI showed lower quadriceps strength and maximal oxygen uptake acquired during cardiopulmonary exercise testing. Both male and female patients with SO showed lower quadriceps muscle function and reduced maximal exercise capacity compared to non-SO asthma patients. CONCLUSION Approximately one in five asthma patients presented low ALM when age-sex-BMI-specific ALMI cutoffs were applied. Obesity is common among patients with asthma referred for PR. Among the obese patients, a significant proportion presented SO. Low ALM and SO were associated with worse functional outcomes.
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Affiliation(s)
- Roy Meys
- Department of Research and Development, Ciro, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Felipe V.C. Machado
- Department of Research and Development, Ciro, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
- Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Martijn A. Spruit
- Department of Research and Development, Ciro, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Anouk A.F. Stoffels
- Department of Research and Development, Ciro, Horn, The Netherlands
- Department of Pulmonary Diseases, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hieronymus W.H. van Hees
- Department of Pulmonary Diseases, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bram van den Borst
- Department of Pulmonary Diseases, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter H. Klijn
- Department of Pulmonology, Merem Pulmonary Rehabilitation Centre, Hilversum, The Netherlands
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Chris Burtin
- REVAL–Rehabilitation Research Center, BIOMED–Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Fabio Pitta
- Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Frits M.E. Franssen
- Department of Research and Development, Ciro, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
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Gortan Cappellari G, Guillet C, Poggiogalle E, Ballesteros Pomar MD, Batsis JA, Boirie Y, Breton I, Frara S, Genton L, Gepner Y, Gonzalez MC, Heymsfield SB, Kiesswetter E, Laviano A, Prado CM, Santini F, Serlie MJ, Siervo M, Villareal DT, Volkert D, Voortman T, Weijs PJ, Zamboni M, Bischoff SC, Busetto L, Cederholm T, Barazzoni R, Donini LM. Sarcopenic obesity research perspectives outlined by the sarcopenic obesity global leadership initiative (SOGLI) - Proceedings from the SOGLI consortium meeting in rome November 2022. Clin Nutr 2023; 42:687-699. [PMID: 36947988 DOI: 10.1016/j.clnu.2023.02.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 02/17/2023] [Indexed: 02/26/2023]
Abstract
The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched the Sarcopenic Obesity Global Leadership Initiative (SOGLI) to reach expert consensus on a definition and diagnostic criteria for Sarcopenic Obesity (SO). The present paper describes the proceeding of the Sarcopenic Obesity Global Leadership Initiative (SOGLI) meeting that was held on November 25th and 26th, 2022 in Rome, Italy. This consortium involved the participation of 50 researchers from different geographic regions and countries. The document outlines an agenda advocated by the SOGLI expert panel regarding the pathophysiology, screening, diagnosis, staging and treatment of SO that needs to be prioritized for future research in the field.
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Affiliation(s)
| | - Christelle Guillet
- University of Clermont Auvergne, INRA, CRNH, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | | | - John A Batsis
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yves Boirie
- University of Clermont Auvergne, INRA, CRNH, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Irene Breton
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Stefano Frara
- Università Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | | | | | | | - Eva Kiesswetter
- Institute for Evidence in Medicine, Medical Center & Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | | | | | | | | | | | - Dorothee Volkert
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Trudy Voortman
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Peter Jm Weijs
- Amsterdam University Medical Centers, Amsterdam, the Netherlands; Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | | | | | | | - Tommy Cederholm
- Uppsala University and Karolinska University Hospital, Stockholm, Sweden
| | - Rocco Barazzoni
- Department of Medical Sciences, University of Trieste, Trieste, Italy
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9
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Ambroselli D, Masciulli F, Romano E, Catanzaro G, Besharat ZM, Massari MC, Ferretti E, Migliaccio S, Izzo L, Ritieni A, Grosso M, Formichi C, Dotta F, Frigerio F, Barbiera E, Giusti AM, Ingallina C, Mannina L. New Advances in Metabolic Syndrome, from Prevention to Treatment: The Role of Diet and Food. Nutrients 2023; 15:640. [PMID: 36771347 PMCID: PMC9921449 DOI: 10.3390/nu15030640] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 01/28/2023] Open
Abstract
The definition of metabolic syndrome (MetS) has undergone several changes over the years due to the difficulty in establishing universal criteria for it. Underlying the disorders related to MetS is almost invariably a pro-inflammatory state related to altered glucose metabolism, which could lead to elevated cardiovascular risk. Indeed, the complications closely related to MetS are cardiovascular diseases (CVDs) and type 2 diabetes (T2D). It has been observed that the predisposition to metabolic syndrome is modulated by complex interactions between human microbiota, genetic factors, and diet. This review provides a summary of the last decade of literature related to three principal aspects of MetS: (i) the syndrome's definition and classification, pathophysiology, and treatment approaches; (ii) prediction and diagnosis underlying the biomarkers identified by means of advanced methodologies (NMR, LC/GC-MS, and LC, LC-MS); and (iii) the role of foods and food components in prevention and/or treatment of MetS, demonstrating a possible role of specific foods intake in the development of MetS.
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Affiliation(s)
- Donatella Ambroselli
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Fabrizio Masciulli
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Enrico Romano
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Giuseppina Catanzaro
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | | | - Maria Chiara Massari
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Elisabetta Ferretti
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, Health Sciences Section, University “Foro Italico”, 00135 Rome, Italy
| | - Luana Izzo
- Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
| | - Alberto Ritieni
- Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
- UNESCO, Health Education and Sustainable Development, University of Naples Federico II, 80131 Naples, Italy
| | - Michela Grosso
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
| | - Caterina Formichi
- Diabetes Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
| | - Francesco Dotta
- Diabetes Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
| | - Francesco Frigerio
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Eleonora Barbiera
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Anna Maria Giusti
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Cinzia Ingallina
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Luisa Mannina
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
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Anusitviwat C, Vanitcharoenkul E, Chotiyarnwong P, Unnanuntana A. Dual-Frequency Bioelectrical Impedance Analysis is Accurate and Reliable to Determine Lean Muscle Mass in The Elderly. J Clin Densitom 2023; 26:90-96. [PMID: 36567160 DOI: 10.1016/j.jocd.2022.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Dual-frequency bioelectrical impedance analysis (DF-BIA) devices are more accessible and affordable than dual-energy X-ray absorptiometry (DXA); however, no studies have reported the accuracy of DF-BIA in body composition measurement, especially in the Thai elderly. The aims of this study were to (1) compare the accuracies of lean muscle masses measured by DF-BIA devices and DXA and (2) assess the reliability of the DF-BIA device. METHODS This cross-sectional study was conducted on participants older than 60 years who visited the Orthopedic Clinic of Siriraj Hospital. Whole-body and appendicular skeletal muscle masses (ASMs) were measured using DF-BIA (Tanita RD-545), with DXA (GE Lunar iDXA) as the standard reference. The test-retest reliability of the DF-BIA and the agreement between the devices were assessed using the intraclass correlation coefficient (ICC) and Bland-Altman plots. Regression analysis was used to develop an equation to estimate ASM values from BIA close to those from DXA. RESULTS The mean age of 88 participants was 73.8 (SD 8.0) years, with women predominating (84.1%). The agreement of BIA and DXA was very high for whole-body lean mass (ICC = 0.954) and ASM (ICC = 0.954), but the mean difference in muscle mass from DF-BIA was overestimated. The ICCs of test-retest reliability for whole-body muscle mass and ASM were 0.987 and 0.988, respectively. The equation for corrected ASM was formulated from a linear equation (R2 = 0.93). CONCLUSIONS Although lean muscle mass from DF-BIA was minimally overestimated relative to DXA, this device had high accuracy and reliability for lean muscle mass evaluation in the elderly. DXA and DF-BIA are interchangeable for the assessment of muscle mass.
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Affiliation(s)
- Chirathit Anusitviwat
- Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Ekasame Vanitcharoenkul
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Pojchong Chotiyarnwong
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Aasis Unnanuntana
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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11
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De Lorenzo A, Pellegrini M, Gualtieri P, Itani L, El Ghoch M, Di Renzo L. The Risk of Sarcopenia among Adults with Normal-Weight Obesity in a Nutritional Management Setting. Nutrients 2022; 14:nu14245295. [PMID: 36558454 PMCID: PMC9786616 DOI: 10.3390/nu14245295] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022] Open
Abstract
Normal-weight obesity (NWO) is a phenotype characterized by excessive body fat (BF) despite normal body weight. We aimed to assess the association between NWO and the risk of sarcopenia. Two groups of patients with a normal body mass index [BMI (20-24.9 kg/m2)] were selected from a large cohort of participants. Body composition was measured using dual-energy X-ray absorptiometry (DXA), and 748 participants were categorized as NWO or normal-weight without obesity (NWNO) and were classed according to whether or not they were at risk of sarcopenia. The "NWO group" included 374 participants (cases), compared to 374 participants (controls) in the "NWNO group", all of a similar BMI, age and gender. The participants in the "NWO group" displayed a higher prevalence of the risk of sarcopenia than the control group across both genders (0.6% vs. 14.1% in males; 1.4% vs. 36.5% in females). Regression analysis showed that being in the NWO category increased the risk of sarcopenia 22-fold in males (RR = 22.27; 95%CI: 3.35-147.98) and 25-fold in females (RR = 25.22; 95%CI: 8.12-78.36), compared to those in the NWNO category. In a "real-world" nutritional setting, the assessment of body composition to identify NWO syndrome is vital since it is also associated with a higher risk of sarcopenia.
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Affiliation(s)
- Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Massimo Pellegrini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Paola Gualtieri
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut 11072809, Lebanon
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut 11072809, Lebanon
- Correspondence: or
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
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12
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Zambon Azevedo V, Ponnaiah M, Bel Lassen P, Ratziu V, Oppert JM. A diagnostic proposal for sarcopenic obesity in adults based on body composition phenotypes. Clin Nutr ESPEN 2022; 52:119-130. [PMID: 36513443 DOI: 10.1016/j.clnesp.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND & AIMS Sarcopenic obesity (SO) associates a decrease in lean body mass (LBM) with an excessive increase in fat mass (FM). A number of diagnostic methods, definitions criteria, and thresholds have been proposed for SO resulting in markedly discordant prevalence estimates in populations with obesity. In this study, we first assessed several previously described SO diagnostic criteria and their limitations, and then we propose an innovative approach for identifying SO. METHODS Data were from a cross-sectional study of a cohort of overweight/obese patients who underwent clinical, laboratory, and body composition assessments by dual-energy X-ray absorptiometry (DXA). We performed unsupervised machine learning through clustering analysis to discriminate lean and fat compartments, and multivariate logistic regressions which provided prognostic variables applied on sex-specific models for SO diagnosis evaluation based on a training dataset (80% of total sample, n = 1165). The predicted models were validated by random forest (RF) machine learning algorithm in the validation dataset (20% of total sample, n = 262). RESULTS Data from 1427 subjects were analyzed, 79.8% women, mean (±s.d.) age 45.0 (±12.9) years, grade III obesity (BMI over 40 kg/m2) in 42.7%, diabetes in 20.7%, dyslipidemia in 86.3%, and arterial hypertension in 30.3%. Patients with grade III obesity had higher amounts of LBM, FM, and bone mass than subjects with overweight (BMI between 25.0 and 29.9 kg/m2) (p-values < 0.001). When published definitions of SO were applied to this cohort, the prevalence ranged from 0.6% to 96.6%. We built a model that identified 62 (4.3%) individuals as SO, 1125 (78.9%) as non-SO, and 240 (16.8%) as borderline-SO. SO patients showed higher body weight, FM, bone mass, leptin levels, and hepatic steatosis index, but lower LBM and all muscle indexes than non-SO subjects (p-values ≤ 0.001). Patients in the SO and borderline-SO categories were more often females than males (4.5% vs. 3.8% and 16.9% vs. 16.7% respectively, p-value < 0.001) and had significantly higher prevalence of metabolic syndrome and hypertension than non-SO subjects. Males with SO also had higher cardiovascular risk score, while females had higher prevalence of respiratory disorders (p-values < 0.05 for all). CONCLUSIONS Current diagnostic criteria for SO result in widely discrepant prevalence values leading to diagnosis uncertainty. We developed and validated diagnostic criteria based on body composition phenotypes, specifically for overweight/obese subjects, which identified patients at risk of cardio-metabolic complications. This approach may improve the identification of sarcopenia in subjects with obesity.
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Affiliation(s)
- Vittoria Zambon Azevedo
- Sorbonne Université, Paris, France; Centre de Recherche de Cordeliers, INSERM UMRS 1138, Paris, France; Foundation for Innovation in Cardiometabolism and Nutrition, IHU ICAN, Paris, France.
| | - Maharajah Ponnaiah
- ICAN I/O - Data Science, Foundation for Innovation in Cardiometabolism and Nutrition, IHU ICAN, Paris, France
| | - Pierre Bel Lassen
- Sorbonne Université, Inserm, Nutrition and Obesity: Systemic Approaches Research Unit, NutriOmics, Paris, France; Assistance Publique Hôpitaux de Paris (AP-HP), Service de Nutrition, Hôpital Pitié-Salpêtrière, Paris, France
| | - Vlad Ratziu
- Sorbonne Université, Paris, France; Centre de Recherche de Cordeliers, INSERM UMRS 1138, Paris, France; Foundation for Innovation in Cardiometabolism and Nutrition, IHU ICAN, Paris, France; Assistance Publique Hôpitaux de Paris (AP-HP), Service d'Hépatologie et Gastro-entérologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jean-Michel Oppert
- Sorbonne Université, Paris, France; Foundation for Innovation in Cardiometabolism and Nutrition, IHU ICAN, Paris, France; Assistance Publique Hôpitaux de Paris (AP-HP), Service de Nutrition, Hôpital Pitié-Salpêtrière, Paris, France
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13
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Kumari M, Khanna A. Prevalence of Sarcopenic Obesity in Various Comorbidities, Diagnostic Markers, and Therapeutic Approaches: A Review. Ann Geriatr Med Res 2022; 26:296-308. [PMID: 36397294 PMCID: PMC9830070 DOI: 10.4235/agmr.22.0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 10/31/2022] [Indexed: 11/20/2022] Open
Abstract
The coexistence of sarcopenia and obesity characterizes sarcopenic obesity. In this condition, there is an imbalance between lean and fat mass amounts. It is a prevalent issue that is gaining prevalence among the elderly population. To evaluate the condition, allied health professionals may employ non-invasive diagnostic techniques, such as gait speed, skeletal muscle mass, and muscle strength. Nevertheless, early diagnosis and treatment of pathology are essential for preventing debilitating effects and providing the highest quality of care. This article reviews the prevalence of sarcopenic obesity in numerous medical conditions, such as cancer, arthritis, postoperative cases, diabetes mellitus, obesity, and metabolic syndrome. In addition, this paper aims to examine the available evidence regarding the prevalence of sarcopenic obesity in other conditions along with their diagnostic markers and therapeutic approaches.
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Affiliation(s)
- Mangalam Kumari
- Department of Physiotherapy, School of Allied Health Sciences, Sharda University, Greater Noida, Uttar Pradesh 201306, India
| | - Archana Khanna
- Department of Physiotherapy, School of Allied Health Sciences, Sharda University, Greater Noida, Uttar Pradesh 201306, India,Corresponding Author: Archana Khanna, PhD Department of Physiotherapy, School of Allied Health Sciences, Sharda University, Greater Noida, Uttar Pradesh 201306, India E-mail:
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El Ghoch M, Rossi AP, Verde L, Barrea L, Muscogiuri G, Savastano S, Colao A. Understanding sarcopenic obesity in young adults in clinical practice: a review of three unsolved questions. Panminerva Med 2022; 64:537-547. [PMID: 36533664 DOI: 10.23736/s0031-0808.22.04784-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
INTRODUCTION Our aim was to summarize the available literature on three yet unsolved questions, namely: 1) the dilemma surrounding definition of sarcopenic obesity (SO), especially in young adults; 2) the potential impact of this phenotype on weight-loss programme outcomes; and 3) the strategies for optimum management (prevention/treatment) of SO in clinical practice. EVIDENCE ACQUISITION A literature review using the PubMed/Medline database was conducted, and data were summarized based on a narrative approach. EVIDENCE SYNTHESIS Firstly, SO can be screened by the 30-sec sit-to-stand test; ≤25 and ≤21; and confirmed by the ratio of (appendicular lean mass/Body Mass Index) ≤0.789 and 0.512 in males and females, respectively. Secondly, SO is associated with impaired physical fitness, reduced resting energy expenditure and an inactive lifestyle, that seems to negatively impact on weight-management outcomes, namely increasing early dropout and difficulty in maintaining weight loss in the long term. Finally, prevention/treatment of SO in young adults must be realized through tailored lifestyle intervention (diet+exercise) to preserve and improve strength and muscle mass, even where weight loss is necessary. CONCLUSIONS Our findings have clinical implications since they may help in screening, managing and improving the weight-loss outcomes of patients with SO in clinical settings.
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Affiliation(s)
- Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Arab University of Beirut, Beirut, Lebanon
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea P Rossi
- Division of Geriatrics, Department of Medicine, Healthy Aging Center, University of Verona, Verona, Italy
- Division of Geriatrics, Department of Medicine, Ospedale Ca' Foncello ULSS2 Treviso, Treviso, Italy
| | - Ludovica Verde
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Luigi Barrea
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- Department of Human Sciences, Pegaso Telematic University, Naples, Italy
| | - Giovanna Muscogiuri
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy -
- Department of Clinical Medicine and Surgery, Section of Endocrinology, University Federico II, Naples, Italy
- UNESCO Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
| | - Silvia Savastano
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- Department of Clinical Medicine and Surgery, Section of Endocrinology, University Federico II, Naples, Italy
| | - Annamaria Colao
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- Department of Clinical Medicine and Surgery, Section of Endocrinology, University Federico II, Naples, Italy
- UNESCO Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
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Lai TF, Liao Y, Hsueh MC, Yen HY, Park JH, Chang JH. Substituting sedentary time with physical activity in youngest-old to oldest-old community-dwelling older adults: Associations with body composition. Front Public Health 2022; 10:837213. [PMID: 36523577 PMCID: PMC9746713 DOI: 10.3389/fpubh.2022.837213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 11/07/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Several studies have suggested that physical activity and sedentary behavior are strongly and independently associated with body composition and obesity. However, few studies have investigated whether substituting sedentary time with moderate-to-vigorous physical activity is associated with body composition in older adults, especially among those older than 75 years. Methods This study examined the associations between replacing sedentary time with physical activity and obesity indices in a sample of 199 community-dwelling older Taiwanese adults (52.3% women; 80.6 ± 7.0 years). Physical activity and sedentary behavior were measured using the triaxial accelerometer (GT3X+, ActiGraph). Body composition indices were computed through a bioelectrical impedance analysis of body fat percentage and appendicular skeletal muscle mass index. Waist circumference and body mass index were measured by trained personnel. Isotemporal substitution analyses estimated these associations after adjusting for sociodemographic characteristics and nutritional status. Results The study showed that substituting 30 min of sedentary behavior per day with moderate-to-vigorous physical activity was associated with lower body fat percentage (B = -1.408, 95% CI = -2.55, -0.264), body mass index (B = -0.681, 95% CI = -1.300, -0.061), and waist circumference (B = -2.301, 95% CI = -4.062, -0.539) after adjusting for covariates. Substituting 30 min of light physical activity per day with moderate-to-vigorous physical activity was associated with lower waist circumference (B = -2.230, 95% CI = -4.173, -0.287) after adjusting for covariates. Stratified analyses indicated that associations were stronger in youngest-old older adults, and in older adults with a normal nutritional status (vs. underweight status). Discussion These findings confirm the importance of reducing sedentary behavior and increasing moderate-to-vigorous physical activity among older adults to improve their physical health, as well as highlighting the importance of taking into account nutritional status and age group.
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Affiliation(s)
- Ting-Fu Lai
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Yung Liao
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan
| | - Ming-Chun Hsueh
- Master's Program of Transition and Leisure Education for Individuals With Disabilities, University of Taipei, Taipei, Taiwan
| | - Hsin-Yen Yen
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Jong-Hwan Park
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea,*Correspondence: Jong-Hwan Park
| | - Jae Hyeok Chang
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Busan, South Korea,Jae Hyeok Chang
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Holanda N, Crispim N, Carlos I, Moura T, Nóbrega E, Bandeira F. Musculoskeletal effects of obesity and bariatric surgery – a narrative review. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:621-632. [PMID: 36382751 PMCID: PMC10118826 DOI: 10.20945/2359-3997000000551] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Obesity affects several areas of the human body, leading to increased morbidity and mortality and the likelihood of other diseases, such as type 2 diabetes mellitus, cardiovascular diseases and musculoskeletal disorders. These conditions predispose to bone fractures and sarcopenic obesity, defined by the presence of an obesity-associated decrease in muscle mass and strength. Both bone fragility and sarcopenic obesity disease are consequences of several factors, such as a low degree of chronic inflammation, insulin resistance, hormonal changes, nutritional deficiencies, ectopic fat deposits and sedentary lifestyle. The diagnosis of obesity-related musculoskeletal disorders is limited by the lack of sarcopenia criteria and lower accuracy of bone mineral density measurement by dual-energy X-ray absorptiometry in overweight people. Reducing body weight provides undeniable benefits to this population, however treating cases of severe obesity with bariatric surgery can cause even greater damage to bone and muscle health, especially in the long term. The mechanisms involved in this process are not yet fully understood, but factors related to nutrient malabsorption and mechanical discharge as well as changes in gut hormones, adipokines and bone marrow adiposity should be taken into account. Depending on the surgical technique performed, greater musculoskeletal damage may occur, especially in cases of malabsorptive surgeries such as Roux-en-Y gastric bypass, when compared to restrictive techniques such as sleeve gastrectomy. This difference is probably due to greater weight loss, nutrient malabsorption and important hormonal changes that occur as a consequence of the diversion of intestinal transit and loss of greater absorptive surface. Thus, people undergoing bariatric procedures, especially malabsorptive ones, should have their musculoskeletal health supervised to allow early diagnosis and appropriate therapeutic interventions to prevent osteoporotic fractures and preserve the functionality of the skeletal muscles.
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Organokines, Sarcopenia, and Metabolic Repercussions: The Vicious Cycle and the Interplay with Exercise. Int J Mol Sci 2022; 23:ijms232113452. [PMID: 36362238 PMCID: PMC9655425 DOI: 10.3390/ijms232113452] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/26/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022] Open
Abstract
Sarcopenia is a disease that becomes more prevalent as the population ages, since it is directly linked to the process of senility, which courses with muscle atrophy and loss of muscle strength. Over time, sarcopenia is linked to obesity, being known as sarcopenic obesity, and leads to other metabolic changes. At the molecular level, organokines act on different tissues and can improve or harm sarcopenia. It all depends on their production process, which is associated with factors such as physical exercise, the aging process, and metabolic diseases. Because of the seriousness of these repercussions, the aim of this literature review is to conduct a review on the relationship between organokines, sarcopenia, diabetes, and other metabolic repercussions, as well the role of physical exercise. To build this review, PubMed-Medline, Embase, and COCHRANE databases were searched, and only studies written in English were included. It was observed that myokines, adipokines, hepatokines, and osteokines had direct impacts on the pathophysiology of sarcopenia and its metabolic repercussions. Therefore, knowing how organokines act is very important to know their impacts on age, disease prevention, and how they can be related to the prevention of muscle loss.
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Pellegrini M, Itani L, Rossi AP, Kreidieh D, El Masri D, Tannir H, El Ghoch M. Approaching Sarcopenic Obesity in Young and Middle-Aged Female Adults in Weight Management Settings: A Narrative Review. Healthcare (Basel) 2022; 10:healthcare10102042. [PMID: 36292489 PMCID: PMC9601683 DOI: 10.3390/healthcare10102042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/03/2022] [Accepted: 10/13/2022] [Indexed: 11/04/2022] Open
Abstract
This paper presents a review of the available literature on sarcopenic obesity (SO) in young and middle-aged female adults with obesity in weight management settings. A literature review using the PubMed/Medline and Science Direct databases was conducted, and the data were summarized through a narrative approach. Firstly, some physical performance tests and questionnaires are available for screening young and middle-aged female adults with a high risk of SO. Secondly, these patients can undergo instrumental measurements such as dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA) to confirm or reject a diagnosis of SO, applying definitions that account for body mass. Thirdly, SO is a prevalent phenotype in females seeking weight management treatment, as well as being strongly associated (vs. non-SO) with obesity-related comorbidities that need to be promptly managed, initially with nutritional programs or/and in combination with medications. Finally, patients with SO have a reduced baseline resting energy expenditure and more sedentary behaviors, which seem to account for the relationship between SO and poorer weight management outcomes, such as a higher early dropout rate and major later difficulties in weight loss maintenance. Therefore, specific strategies for personalized weight management programs for patients with SO should be incorporated to determine a successful management of this phenotype.
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Affiliation(s)
- Massimo Pellegrini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287, 41125 Modena, Italy
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon
| | - Andrea P. Rossi
- Geriatric Division, Department of Medicine, Ospedale Cà Foncello ULSS2 Treviso, Piazzale Ospedale 1, 31100 Treviso, Italy
- Healthy Aging Center, Department of Medicine, Division of Geriatric, University of Verona, 37126 Verona, Italy
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon
| | - Dana El Masri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon
| | - Hana Tannir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon
| | - Marwan El Ghoch
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287, 41125 Modena, Italy
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon
- Correspondence: or
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19
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Wu J, Cao L, Wang J, Wang Y, Hao H, Huang L. Characterization of serum protein expression profiles in the early sarcopenia older adults with low grip strength: a cross-sectional study. BMC Musculoskelet Disord 2022; 23:894. [PMID: 36192674 PMCID: PMC9528053 DOI: 10.1186/s12891-022-05844-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background Sarcopenia refers to the progressive loss of skeletal muscle mass and muscle function, which seriously threatens the quality of life of the older adults. Therefore, early diagnosis is urgently needed. This study aimed to explore the changes of serum protein profiles in sarcopenia patients through a cross-sectional study, and to provide the reference for clinical diagnosis. Methods This study was a cross-sectional study carried out in the Tianjin institute of physical education teaching experiment training center from December 2019 to December 2020. Ten older adults were recruited, including 5 sarcopenia and 5 healthy older adults. After a detailed diagnostic evaluation, blood samples were collected to prepare serum for proteomic analysis using the HPLC System Easy nLC method. The differentially expressed proteins (DEPs) were screened by the limma package of R software (version 4.1.0). Results A total of 114 DEPs were identified between the patients and healthy older adults, including 48 up-regulated proteins and 66 down-regulated proteins. The functional enrichment analysis showed that the 114 DEPs were significantly enriched in 153 GO terms, which mainly involved in low-density lipoprotein particle remodeling, and negative regulation of immune response,etc. The PPI network further suggested that the cholesteryl ester transfer protein and Apolipoprotein A2 could serve as biomarkers to facilitate diagnosis of sarcopenia. Conclusions This study provided a serum proteomic profile of sarcopenia patients, and identified two proteins with diagnostic value, which might help to improve the diagnostic accuracy of sarcopenia. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05844-2.
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Affiliation(s)
- Jingqiong Wu
- TianJin University of Sport, No.16 Donghai Road, West Tuanbo New Town, Jinghai District, Tianjin, 301617, PR China.,Guangxi Medical University, Nanning, 530021, Guangxi, PR China
| | - Longjun Cao
- TianJin University of Sport, No.16 Donghai Road, West Tuanbo New Town, Jinghai District, Tianjin, 301617, PR China
| | - Jiazhi Wang
- TianJin University of Sport, No.16 Donghai Road, West Tuanbo New Town, Jinghai District, Tianjin, 301617, PR China
| | - Yizhao Wang
- Tianjin Huanhu Hospital, Tianjin, 300350, PR China
| | - Huimin Hao
- TianJin University of Sport, No.16 Donghai Road, West Tuanbo New Town, Jinghai District, Tianjin, 301617, PR China
| | - Liping Huang
- TianJin University of Sport, No.16 Donghai Road, West Tuanbo New Town, Jinghai District, Tianjin, 301617, PR China.
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20
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Gangitano E, Barbaro G, Susi M, Rossetti R, Spoltore ME, Masi D, Tozzi R, Mariani S, Gnessi L, Lubrano C. Growth Hormone Secretory Capacity Is Associated with Cardiac Morphology and Function in Overweight and Obese Patients: A Controlled, Cross-Sectional Study. Cells 2022; 11:cells11152420. [PMID: 35954264 PMCID: PMC9367721 DOI: 10.3390/cells11152420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 12/10/2022] Open
Abstract
Obesity is associated with increased cardiovascular morbidity. Adult patients with growth hormone deficiency (GHD) show morpho-functional cardiological alterations. A total of 353 overweight/obese patients are enrolled in the period between 2009 and 2019 to assess the relationships between GH secretory capacity and the metabolic phenotype, cardiovascular risk factors, body composition and cardiac echocardiographic parameters. All patients underwent GHRH + arginine test to evaluate GH secretory capacity, DEXA for body composition assessment and transthoracic echocardiography. Blood samples are also collected for the evaluation of metabolic parameters. In total, 144 patients had GH deficiency and 209 patients had normal GH secretion. In comparing the two groups, we found significant differences in body fat distribution with predominantly visceral adipose tissue accumulation in GHD patients. Metabolic syndrome is more prevalent in the GHD group. In particular, fasting glycemia, triglycerides and systolic and diastolic blood pressure are found to be linearly correlated with GH secretory capacity. Epicardial fat thickness, E/A ratio and indexed ventricular mass are worse in the GHD group. In the population studied, metabolic phenotype, body composition, cardiovascular risk factors and cardiac morphology are found to be related to the GH secretory capacity. GH secretion in the obese patient seems to be an important determinant of metabolic health.
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Affiliation(s)
- Elena Gangitano
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Giuseppe Barbaro
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Martina Susi
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Rebecca Rossetti
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Maria Elena Spoltore
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Davide Masi
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Rossella Tozzi
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Stefania Mariani
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Lucio Gnessi
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Carla Lubrano
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
- Correspondence:
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21
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Vieira FT, Godziuk K, Lamarca F, Melendez-Araújo MS, Lima RM, Prado CM, de Carvalho KMB, Dutra ES. Sarcopenic obesity diagnosis by different criteria mid-to long-term post-bariatric surgery. Clin Nutr 2022; 41:1932-1941. [DOI: 10.1016/j.clnu.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/23/2022] [Accepted: 07/03/2022] [Indexed: 11/16/2022]
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22
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Bulut G, Atci N. Sarcopenic obesity in early breast cancer patients with metabolic syndrome: a cross-sectional study. Future Oncol 2022; 18:2489-2498. [PMID: 35543029 DOI: 10.2217/fon-2022-0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The importance of sarcopenic obesity (SO) in malignancy has recently been recognized. The authors aimed to investigate the clinical and body composition data of early-stage breast cancer (BC) patients by focusing on the components of metabolic syndrome (MetS) and SO. Methods: In this cross-sectional study with early-stage BC patients, the clinical and laboratory results were evaluated for diagnosing MetS. Bioimpedance analysis and muscle radiation attenuation (Hounsfield unit average calculation [HUAC]) using acquired computed tomography images were used to assess SO. Results: The age at diagnosis, BMI, visceral fat ratio, hemoglobin A1c and carcinoembryonic antigen levels in patients with MetS were significantly higher (p < 0.05). A cutoff value of 39.4 Hounsfield units was significantly related to MetS with 76.5% sensitivity and 62% specificity. The mean HUAC in patients with MetS (36.9) was significantly lower than in those without MetS (41.4; p = 0.017). Conclusion: HUAC value predicted SO in early-stage BC patients with MetS.
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Affiliation(s)
- Gulcan Bulut
- International Medicana Hospital, Department of Medical Oncology, Izmir, 35170, Turkey
| | - Nesrin Atci
- Mozaik Hospital, Department of Radiology, Hatay, 31070, Turkey
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23
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Pujia R, Tarsitano MG, Arturi F, De Lorenzo A, Lenzi A, Pujia A, Montalcini T. Advances in Phenotyping Obesity and in Its Dietary and Pharmacological Treatment: A Narrative Review. Front Nutr 2022; 9:804719. [PMID: 35242796 PMCID: PMC8885626 DOI: 10.3389/fnut.2022.804719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/21/2022] [Indexed: 12/20/2022] Open
Abstract
In recent times, it has become evident that there are individuals who, from a metabolic point of view, are affected by obesity but have a normal body mass index. There are also metabolically healthy individuals with a high body mass index who are thus are considered as to be affected by obesity obese. Understanding that individuals with obesity are phenotypically heterogeneous is a relatively novel concept which, although present in the scientific literature, unfortunately has not yet had an impact in clinical practice. However, common dietary approaches are not effective in treating large numbers of obese patients with obesity. This narrative review, based on the material searched via PubMed and the Web of Science up to October 2021, proposes a downsizing of the role of the body mass index in identifying the individual with “true obesity” since it is only partially useful, and suggests a new approach which also integrates the body composition and assessment of metabolic parameters. This approach leads to personalized therapies that work best for each obesity phenotype in reducing the risk of non-communicable diseases.
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Affiliation(s)
- Roberta Pujia
- Department of Medical and Surgical Science Nutrition Unit, University Magna Grecia, Catanzaro, Italy
| | - Maria Grazia Tarsitano
- Department of Medical and Surgical Science Nutrition Unit, University Magna Grecia, Catanzaro, Italy
| | - Franco Arturi
- Department of Medical and Surgical Science Nutrition Unit, University Magna Grecia, Catanzaro, Italy
| | - Antonino De Lorenzo
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, University La Sapienza, Rome, Italy
| | - Arturo Pujia
- Department of Medical and Surgical Science Nutrition Unit, University Magna Grecia, Catanzaro, Italy
| | - Tiziana Montalcini
- Department of Clinical and Experimental Medicine, Nutrition Unit, University Magna Grecia, Catanzaro, Italy
- *Correspondence: Tiziana Montalcini
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24
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Donini LM, Busetto L, Bischoff SC, Cederholm T, Ballesteros-Pomar MD, Batsis JA, Bauer JM, Boirie Y, Cruz-Jentoft AJ, Dicker D, Frara S, Frühbeck G, Genton L, Gepner Y, Giustina A, Gonzalez MC, Han HS, Heymsfield SB, Higashiguchi T, Laviano A, Lenzi A, Nyulasi I, Parrinello E, Poggiogalle E, Prado CM, Salvador J, Rolland Y, Santini F, Serlie MJ, Shi H, Sieber CC, Siervo M, Vettor R, Villareal DT, Volkert D, Yu J, Zamboni M, Barazzoni R. Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement. Clin Nutr 2022; 41:990-1000. [DOI: 10.1016/j.clnu.2021.11.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 02/08/2023]
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25
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Donini LM, Busetto L, Bischoff SC, Cederholm T, Ballesteros-Pomar MD, Batsis JA, Bauer JM, Boirie Y, Cruz-Jentoft AJ, Dicker D, Frara S, Frühbeck G, Genton L, Gepner Y, Giustina A, Gonzalez MC, Han HS, Heymsfield SB, Higashiguchi T, Laviano A, Lenzi A, Nyulasi I, Parrinello E, Poggiogalle E, Prado CM, Salvador J, Rolland Y, Santini F, Serlie MJ, Shi H, Sieber CC, Siervo M, Vettor R, Villareal DT, Volkert D, Yu J, Zamboni M, Barazzoni R. Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement. Obes Facts 2022; 15:321-335. [PMID: 35196654 PMCID: PMC9210010 DOI: 10.1159/000521241] [Citation(s) in RCA: 203] [Impact Index Per Article: 101.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 11/26/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases) and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred to as sarcopenic obesity (SO), a condition increasingly recognized for its clinical and functional features that negatively influence important patient-centred outcomes. Effective prevention and treatment strategies for SO are urgently needed, but efforts are hampered by the lack of a universally established SO definition and diagnostic criteria. Resulting inconsistencies in the literature also negatively affect the ability to define prevalence as well as clinical relevance of SO for negative health outcomes. AIMS AND METHODS The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched an initiative to reach expert consensus on a definition and diagnostic criteria for SO. The jointly appointed international expert panel proposes that SO is defined as the co-existence of excess adiposity and low muscle mass/function. The diagnosis of SO should be considered in at-risk individuals who screen positive for a co-occurring elevated body mass index or waist circumference, and markers of low skeletal muscle mass and function (risk factors, clinical symptoms, or validated questionnaires). Diagnostic procedures should initially include assessment of skeletal muscle function, followed by assessment of body composition where presence of excess adiposity and low skeletal muscle mass or related body compartments confirm the diagnosis of SO. Individuals with SO should be further stratified into stage I in the absence of clinical complications or stage II if cases are associated with complications linked to altered body composition or skeletal muscle dysfunction. CONCLUSIONS ESPEN and EASO, as well as the expert international panel, advocate that the proposed SO definition and diagnostic criteria be implemented into routine clinical practice. The panel also encourages prospective studies in addition to secondary analysis of existing data sets, to study the predictive value, treatment efficacy and clinical impact of this SO definition.
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Affiliation(s)
| | | | | | | | | | - John A. Batsis
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Yves Boirie
- University of Clermont Auvergne, INRA, CRNH, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Dror Dicker
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Stefano Frara
- San Raffaele, Vita-Salute University and IRCCS Hospital, Milan, Italy
| | - Gema Frühbeck
- Clínica Universidad de Navarra, CIBEROBN, IdiSNA, Pamplona, Spain
| | | | | | - Andrea Giustina
- San Raffaele, Vita-Salute University and IRCCS Hospital, Milan, Italy
| | | | - Ho-Seong Han
- Seoul National University Bundang Hospital (SNUBH), Seoul, Republic of Korea
| | | | | | | | | | | | | | | | | | | | - Yves Rolland
- Gerontopole of Toulouse, INSERM 1027, Toulouse University Hospital, Toulouse, France
| | | | | | - Hanping Shi
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Cornel C. Sieber
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Mario Siervo
- University of Nottingham, Nottingham, United Kingdom
| | | | | | - Dorothee Volkert
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Jianchun Yu
- Peking Union Medical College Hospital, Beijing, China
| | | | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- **Rocco Barazzoni,
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26
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Gong H, Liu Y, Lyu X, Dong L, Zhang X. Lipoprotein subfractions in patients with sarcopenia and their relevance to skeletal muscle mass and function. Exp Gerontol 2021; 159:111668. [PMID: 34954281 DOI: 10.1016/j.exger.2021.111668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/09/2021] [Accepted: 12/14/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Loss of skeletal muscle mass is a characteristic of aging. Growing evidence suggests the role of fatty acids and their derived lipid intermediates in the regulation of skeletal muscle and function. However, the exact association between lipoprotein subfractions and sarcopenia in elderly individuals remains unclear. In this study, we aimed to investigate the levels of lipoprotein subfractions in sarcopenia patients and their relationship with skeletal muscle mass and function. METHODS A total of 84 elderly Chinese subjects aged ≥65 years who did not have diseases that obviously affected lipid metabolism were included. Concentrations of lipoprotein subfractions, including total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), HDL2, HDL3, low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), VLDL3, LDL-particle (LDL-P), lipoprotein(a) and remnant-like particle cholesterol (RLP-C), were determined by vertical auto profile. Triglyceride (TG) was measured by an enzymatic colorimetric assay. The skeletal muscle index (SMI) was assessed by bioelectrical impedance analysis. Handgrip strength was measured using a hand-held dynamometer. RESULTS The levels of TC, TG, LDL-C, LDL-P, IDL, VLDL, VLDL3, RLP-C and C-reactive protein were significantly higher in sarcopenia patients than in controls (p < 0.05). Pearson Product-Moment Correlation Coefficient analysis showed that the TC, TG, LDL-C, IDL, VLDL, VLDL3, and RLP-C levels were negatively associated with the SMI; The TG, IDL, VLDL, VLDL3, and RLP-C were negatively correlated with handgrip strength. In multivariate stepwise regression analysis, the VLDL and RLP-C levels were significantly correlated with the SMI. The sensitivity and specificity of the combined measurement of VLDL and RLP-C in predicting sarcopenia were 69.8% and 92.5% (AUC: 0.831; 95% CI:(0.739, 0.924); p < 0.05). CONCLUSION The occurrence of sarcopenia is associated with disorders of lipid metabolism, particularly VLDL and RLP-C.
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Affiliation(s)
- Hui Gong
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Yang Liu
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Xing Lyu
- Laboratory of Clinical Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Lini Dong
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Xiangyu Zhang
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
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Park YJ, Lee YM. Association among the Prevalence of Sarcopenia without Obesity, Nonsarcopenic Obesity, Sarcopenic Obesity, and Metabolic Syndrome in Cancer Survivors: Based on Korea National Health and Nutrition Examination Survey. Asia Pac J Oncol Nurs 2021; 8:679-686. [PMID: 34790852 PMCID: PMC8522597 DOI: 10.4103/apjon.apjon-2116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/19/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: In this study, we aimed to investigate the association among the prevalence of sarcopenia without obesity, nonsarcopenic obesity, sarcopenic obesity, and metabolic syndrome in cancer survivors using data from the 4th and 6th Korea National Health and Nutrition Examination Survey (KNHANES), a nationally representative data source. Methods: The 4th and 6th KNHANES was conducted in 2008–2011. Data from cancer survivors were obtained including 133 obese patients without sarcopenia, 98 obese patients with sarcopenia, and 87 patients with sarcopenia but without obesity. SPSS 22.0 was used for statistical analysis with complex sample survey modules and commands. Results: The prevalence of metabolic syndrome was 25.3% in the sarcopenia without obesity group, 61.7% in the nonsarcopenic obesity group, and 67.3% in the sarcopenic obesity group, showing the highest rate in the sarcopenic obesity group, with a significant difference among the three groups (P < 0.001). Conclusions: In this study, the prevalence of metabolic syndrome was 25.3%, 61.7%, and 67.3% in the sarcopenia without obesity, nonsarcopenic obesity, and sarcopenic obesity groups, respectively, showing that the sarcopenic obesity group had the highest metabolic syndrome rate. Based on these results, various education programs for the prevention and treatment of metabolic syndrome should be developed for cancer patients.
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Affiliation(s)
- Yoon Jin Park
- Department of Nursing, Joongbu University, Chungnam, Korea
| | - Young Mee Lee
- Department of Nursing, Kangwon National University, Samcheok, Korea
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28
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Silva TLD, Mulder AP. Sarcopenia and poor muscle quality associated with severe obesity in young adults and middle-aged adults. Clin Nutr ESPEN 2021; 45:299-305. [PMID: 34620332 DOI: 10.1016/j.clnesp.2021.07.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/14/2021] [Accepted: 07/31/2021] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Sarcopenia is a muscle disease that is associated with a decline in muscle strength and function. When this condition coexists with sarcopenia, it is characterized as sarcopenic obesity (OS), and is associated with worse outcomes of physical functions. The aim of this study was to investigate sarcopenia in obesity and its relationship with body composition in young adults with grade II and grade III obesity. METHODS Analytical, cross-sectional study. Volunteers of both sexes were selected, aged between 20 and 59 years, and who had a BMI ≥35 kg/m2 with the presence of comorbidities or BMI> 40 kg/m2. Body composition was measured by dual-energy X ray absorptiometry (DEXA). The following parameters of sarcopenia included handgrip strength (HGS), chair stand, appendicular skeletal muscle mass (ASM), ASM adjusted by weight and ASM adjusted by BMI; HGS adjusted by ASM and gait speed. RESULTS 108 volunteers, of both sexes, with a mean age of 43, ±11.7 years, were evaluated. 2% had dinapenia and 33% low leg muscle strength. The prevalence of sarcopenia varied between 11.1% and 13.9%, corresponding to the confirmatory criteria of low muscle quantity and low muscle quality, respectively, particularly affecting middle-aged women. We found a reduction in HGS by ASM with an increase in BMI and fat mass (kg) in both age groups, being significant among middle-aged adults (40-59 years). CONCLUSION Even with young adults, we observed changes in all parameters with a negative impact on strength, mass and muscle function. Muscle quality can be considered an important risk factor for functional disability and should be considered in the assessment of sarcopenia. The results show the need to standardize criteria for the assessment of sarcopenia in young adults with severe obesity, since the prevalence differed widely.
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Affiliation(s)
- Tamyris Lira da Silva
- Clinical and Experimental Physiopathology Program, Rio de Janeiro State University, Brazil.
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29
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Wu SE, Chen WL. Transitional states of sarcopenia: the trajectory of fat accumulation and glucose fluctuation on risk of metabolic syndrome. Ann N Y Acad Sci 2021; 1503:60-71. [PMID: 33942910 DOI: 10.1111/nyas.14607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/27/2021] [Accepted: 04/14/2021] [Indexed: 12/21/2022]
Abstract
The association between sarcopenia and metabolic syndrome (MetS) has been well established. Nevertheless, the transition process between normal and low muscle mass (LMM) states and the effect of this transition on MetS has been less explored. Our study here examined whether the direction toward or away from LMM alters the risks of MetS. Initially, gene set enrichment analysis confirmed that MetS correlates with sarcopenia at the genetic level. Subsequently, 6476 eligible participants older than 60 years were enrolled between 2010 and 2016 at Tri-Service General Hospital, Taiwan for evaluation. We discovered an inverse association between the skeletal muscle mass percentage and the risk of MetS. Participants were categorized into four subgroups: state 1 (normal→normal), state 2 (LMM→normal), state 3 (normal→LMM), and state 4 (LMM→LMM). State 4 had increased hazard ratios (HRs) of MetS, while state 2 revealed decreased HRs of MetS, hypertension (HTN), and type II diabetes mellitus (T2DM). State 2 also showed decreased HRs for all five MetS components. Despite the fact that state 3 did not reach statistical significance, increased body fat percentage and glucose fluctuation were observed in this group. The transition direction toward LMM (states 3 and 4) showed deterioration in metabolic indices, leading to increased HRs for MetS, HTN, and T2DM. Conducting timely intervention during this transition process may effectively prevent adverse events accompanying LMM.
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Affiliation(s)
- Shou-En Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of Biochemistry, National Defense Medical Center, Taiwan, Republic of China
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30
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Ahmadi A, Mazloom Z, Eftekhari MH, Masoompour SM, Fararouei M, Eskandari MH, Mehrabi S, Zare M, Sohrabi Z. Muscle mass and function are related to respiratory function in chronic obstructive pulmonary disease. Med J Islam Repub Iran 2021; 35:34. [PMID: 34211936 PMCID: PMC8236085 DOI: 10.47176/mjiri.35.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Indexed: 01/06/2023] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD), as an airway limitation condition, is accompanied by alteration of muscle mass and function. We aimed to determine the relationship between disease severity and body composition, muscle function, and nutritional status in COPD patients. Methods: This cross-sectional study was conducted on 129 COPD participants. Muscle strength, body composition, and calf circumference (CC) were measured using a hydraulic hand dynamometer, bioelectrical impedance analysis (BIA), and a tape measure, respectively. Furthermore, fat-free mass index (FFMI), body mass index (BMI) and muscle mass value were calculated by equations. Forced expiratory volume in one second (FEV1) was assessed as well. Nutritional status was also evaluated by subjective global assessment (SGA) questionnaire. SPSS software (version 21 ) was used, chi-square, fisher's exact test, univariate and multivariate linear regression models were used for statistical analysis. P-values less than 0.05 were considered significant. Results: Based on FEV1 classification, 52.7% of the patients had severe conditions. The reports indicated that the prevalence of low CC was 54.2%, low muscle mass 38.7%, low FFMI 34.8%, low right handgrip strength 61.2% and low left handgrip strength 64.3%. Furthermore, there was an increasing trend based on FEV1 in low CC (p=0.032), low muscle mass (p=0.005), low FFMI (p=0.002), low right handgrip strength (p=0.004) and low left handgrip strength (p=0.014). The results of univariate analysis showed muscle mass (p=0.036), total protein (p=0.043), FFM (p=0.047), FFMI (p=0.007), SGA (p=0.029), right handgrip strength (p=0.004) and left hand grip strength (p=0.023) were associated with FEV1. In addition, the results of multivariate analysis demonstrated low values of FFMI (p=0.005) and right handgrip strength (p=0.042) were the main detrimental factors for FEV1. The results of multivariate analysis were confirmed by stepwise model. Conclusion: Low values of muscle mass and function are prevalent among COPD patients. The present study revealed that low FFMI and handgrip strength were closely related to disease severity.
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Affiliation(s)
- Afsane Ahmadi
- Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Mazloom
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hassan Eftekhari
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sayed Masoom Masoompour
- Noncommunicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hadi Eskandari
- Department of Food Sciences and Technology, School of Agriculture, Shiraz University, Shiraz, Iran
| | - Samrad Mehrabi
- Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Morteza Zare
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Sohrabi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Nickel Sensitivity Is Associated with GH-IGF1 Axis Impairment and Pituitary Abnormalities on MRI in Overweight and Obese Subjects. Int J Mol Sci 2020; 21:ijms21249733. [PMID: 33419306 PMCID: PMC7766406 DOI: 10.3390/ijms21249733] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/10/2020] [Accepted: 12/18/2020] [Indexed: 12/27/2022] Open
Abstract
Nickel (Ni) is a ubiquitous metal, the exposure of which is implied in the development of contact dermatitis (nickel allergic contact dermatitis (Ni-ACD)) and Systemic Ni Allergy Syndrome (SNAS), very common among overweight/obese patients. Preclinical studies have linked Ni exposure to abnormal production/release of Growth Hormone (GH), and we previously found an association between Ni-ACD/SNAS and GH-Insulin-like growth factor 1 (IGF1) axis dysregulation in obese individuals, altogether suggesting a role for this metal as a pituitary disruptor. We herein aimed to directly evaluate the pituitary gland in overweight/obese patients with signs/symptoms suggestive of Ni allergy, exploring the link with GH secretion; 859 subjects with overweight/obesity and suspected of Ni allergy underwent Ni patch tests. Among these, 106 were also suspected of GH deficiency (GHD) and underwent dynamic testing as well as magnetic resonance imaging for routine follow up of benign diseases or following GHD diagnosis. We report that subjects with Ni allergies show a greater GH-IGF1 axis impairment, a higher prevalence of Empty Sella (ES), a reduced pituitary volume and a higher normalized T2 pituitary intensity compared to nonallergic ones. We hypothesize that Ni may be detrimental to the pituitary gland, through increased inflammation, thus contributing to GH-IGF1 axis dysregulation.
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Critical appraisal of definitions and diagnostic criteria for sarcopenic obesity based on a systematic review. Clin Nutr 2020; 39:2368-2388. [DOI: 10.1016/j.clnu.2019.11.024] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/06/2019] [Accepted: 11/06/2019] [Indexed: 12/12/2022]
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Khadra D, Itani L, Chebaro Y, Obeid M, Jaber M, Ghanem R, Ayton A, Kreidieh D, E Masri D, Kimura A, Tannir H, El Ghoch M. Association Between Sarcopenic Obesity and Metabolic Syndrome in Adults: A Systematic Review and Meta-Analysis. Curr Cardiol Rev 2020; 16:153-162. [PMID: 32056530 PMCID: PMC7460704 DOI: 10.2174/1573403x16666200214104122] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/21/2020] [Accepted: 02/06/2020] [Indexed: 01/11/2023] Open
Abstract
Background
In the last two decades, a new phenotype termed Sarcopenic Obesity (SO), in which sarcopenia and obesity coexist, has emerged. Objective
The aim of this systematic review and meta-analysis was first to assess the prevalence of Metabolic syndrome (Mets) among individuals with and without SO, and second, to determine if SO may increase the relative risk of Mets. Methods
This study was conducted in adherence to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and the data were collated by means of meta-analysis and narrative synthesis. Results
Twelve studies including a total of 11,308 adults with overweight or obesity of both genders met the inclusion criteria and were reviewed, revealing two main findings. First, a similar overall prevalence of Mets in individuals with SO (61.49%; 95% CI: 52.19-70.40) when compared to those without SO (56.74%; 95% CI: 47.32-65.93) was identified. Second, the presence of SO appears not to increase the risk of Mets with respect to those without SO (RR = 1.08, 95% CI: 0.99-1.17, p = 0.07). Conclusion
No higher prevalence of Mets among individuals with SO when compared to those with obesity only, nor a significant association between SO and a higher risk of Mets was found.
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Affiliation(s)
- Dima Khadra
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Yomna Chebaro
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - May Obeid
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Miryam Jaber
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Reham Ghanem
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Agnes Ayton
- University of Oxford, Consultant Psychiatrist, Warneford Hospital, Oxford OX3 7JX, United Kingdom
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Dana E Masri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Akira Kimura
- Department of Physical Therapy, Faculty of Health Sciences, Gunma Paz University, Takasaki, Japan
| | - Hana Tannir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
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Machado KLLL, Domiciano DS, Machado LG, Lopes JB, Figueiredo CP, Caparbo VF, Takayama L, Menezes PR, Pereira RMR. Risk Factors for Low Muscle Mass in a Population-based Prospective Cohort of Brazilian Community-dwelling Older Women: The São Paulo Ageing & Health (SPAH) Study. J Clin Densitom 2020; 23:503-510. [PMID: 31174963 DOI: 10.1016/j.jocd.2019.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Sarcopenia is characterized by progressive loss of skeletal muscle mass, which results in decreased muscle strength, functional impairment, and increased risk of death. Few studies have performed a concomitant evaluation of clinical, laboratory, and body composition variables to accurately determine the contribution of each parameter to low muscle mass (LMM) in older subjects. This study aimed to identify risk factors (clinical, laboratory parameters, BMD, and body composition by DXA including visceral fat) for LMM in a prospective cohort of older Brazilian women. METHODS A total of 408 women aged ≥65 yr from the São Paulo Ageing & Health study were evaluated with clinical data, laboratory bone tests, BMD, and body composition by DXA using Hologic QDR 4500A equipment. Risk factors were measured at baseline (2005-2007). After a follow-up of 4.3 ± 0.8 yr, subjects were classified according to the LMM definition of the Foundation for the National Institutes of Health criteria. LMM was defined when appendicular lean mass divided by body mass index was less than 0.512. Multivariate logistic regression models were used to identify independent risk factors for LMM. RESULTS At the end of follow-up, 116 women (28.4%) had LMM. Age averages were 73.3 ± 4.9 yr in the LMM group and 72.5 ± 4.5 yr in the normal group (p = 0.11). Mean BMI was 30.6 ± 5.2 kg/m2 in the LMM group and 28.1 ± 4.7 kg/m2 in the normal group (p < 0.001). In multivariate analyses, predictors of LMM were: falls (OR = 1.14, p = 0.016), TSH levels (OR = 1.08, p = 0.018, per 1 μUI/L-increase), serum creatinine levels (OR = 11.11, p < 0.001, per 1 mg/dL-decrease), and visceral adipose tissue (VAT) mass (OR = 1.17, p < 0.001, per 100 g increase). CONCLUSIONS Falls, high TSH, low creatinine, and high VAT were risk factors for LMM in older women. More attention should be paid to these factors, since they are potentially reversible with adequate intervention.
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Affiliation(s)
- Ketty L L L Machado
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Diogo S Domiciano
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luana G Machado
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Jaqueline B Lopes
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Camille P Figueiredo
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Valeria F Caparbo
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Liliam Takayama
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Paulo R Menezes
- Department of Preventive Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Rosa M R Pereira
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
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Poggiogalle E, Mendes I, Ong B, Prado CM, Mocciaro G, Mazidi M, Lubrano C, Lenzi A, Donini LM, Siervo M. Sarcopenic obesity and insulin resistance: Application of novel body composition models. Nutrition 2020; 75-76:110765. [DOI: 10.1016/j.nut.2020.110765] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 11/08/2019] [Accepted: 01/28/2020] [Indexed: 01/06/2023]
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Cho YJ, Lim YH, Yun JM, Yoon HJ, Park M. Sex- and age-specific effects of energy intake and physical activity on sarcopenia. Sci Rep 2020; 10:9822. [PMID: 32555196 PMCID: PMC7300112 DOI: 10.1038/s41598-020-66249-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 05/19/2020] [Indexed: 01/06/2023] Open
Abstract
Sarcopenia is a common health issue that is not limited to only elderly patients. However, many studies have reported factors to prevent sarcopenia only in susceptible groups. This study evaluates the relationship of the total energy intake to basal metabolic rate ratio (EI/BMR) and physical activity (PA) with sarcopenia. A second aim was to analyze the interaction between EI/BMR and PA by sex and age. We analyzed 16,313 subjects aged ≥ 19 years who had dual‒energy X-ray absorptiometry data. Sarcopenia was defined as appendicular lean mass/weight (%) that was 1 standard deviation below the sex-specific mean value for a young reference group. Multivariate logistic regression analysis was used to examine the interaction between EI/BMR and PA. In this study, as EI/BMR increased, the risk of sarcopenia decreased, particularly in the older groups. Both high PA and high EI/BMR were independently related to the reduced risk of sarcopenia and showed additive effects on reducing the risk in young male and older groups. However, high PA was associated with an increased risk of sarcopenia in the young female group with low energy intake. Our findings suggest that an adequate balance between energy intake and PA is related to a low risk of sarcopenia, especially in young females.
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Affiliation(s)
- Yu Jin Cho
- Department of Family Medicine, Seoul National University, College of Medicine, Seoul, Korea
| | - Youn-Hee Lim
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Jae Moon Yun
- Department of Family Medicine, Seoul National University, College of Medicine, Seoul, Korea
| | - Hyung-Jin Yoon
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea.,Bio-MAX Institute, Seoul National University, Seoul, Korea
| | - Minseon Park
- Department of Family Medicine, Seoul National University, College of Medicine, Seoul, Korea.
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Lim HS. Association of Dietary Variety Status and Sarcopenia in Korean Elderly. J Bone Metab 2020; 27:143-149. [PMID: 32572375 PMCID: PMC7297625 DOI: 10.11005/jbm.2020.27.2.143] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/15/2020] [Accepted: 05/16/2020] [Indexed: 12/25/2022] Open
Abstract
Background Sarcopenia is associated with a variety of factors including age, diseases, exercise, and heredity. In particular, diet is known to affect changes in muscle mass loss. Methods The purpose of this study was to analyze the diversity of food intake according to the presence of sarcopenia in elderly people over 65 years old using the 2008 to 2011 Korea National Health and Nutrition Examination Survey. The differences in subjects' general characteristics, lifestyle, and intake of 15 food groups were compared, and the risk odds ratio (OR) for sarcopenia was calculated for each food intake by gender. Results The proportion of sarcopenia was 27.7% for males and 24.3% for females. The sarcopenia group had significantly lower intakes of nuts and seeds, meats, and milks than the non-sarcopenia group in males. The females had significantly lower intake of fruits, milks, and beverages in non-sarcopenia group. The dietary diversity score was significantly lower in females with sarcopenia than non-sarcopenia group. Regression analysis of the risk OR for sarcopenia according to food group intake showed that the subjects in the lowest tertile (<31.1 g) had a 1.83 times (95% confidence interval [CI], 1.13–2.42) risk for sarcopenia in males. In case of milks intake of females, the risk for sarcopenia increased 1.39 times (95% CI, 1.11–1.86) in subjects with the lowest tertile (<30.1 g). Conclusions Dietary diversity status was the most vulnerable to female with sarcopenia. Sarcopenia was associated with meat intake in male and milk intake in female.
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Affiliation(s)
- Hee-Sook Lim
- Department of Food and Nutrition, Yeonsung University, Anyang, Korea
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Tseng TG, Lu CK, Hsiao YH, Pan SC, Tai CJ, Lee MC. Development of Taiwan Risk Score for Sarcopenia (TRSS) for Sarcopenia Screening among Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082859. [PMID: 32326323 PMCID: PMC7216229 DOI: 10.3390/ijerph17082859] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 01/06/2023]
Abstract
The SARC-F questionnaire has been suggested by the European Working Group on Sarcopenia in Older People (EWGSOP) as a first-step screening tool for sarcopenia. However, the sensitivity to SARC-F is low among community-dwelling older adults. Therefore, this study aimed to develop a new prediction model for sarcopenia screening in the community setting. We conducted a cross-sectional analysis of data from the Taiwan Integration of Health and Welfare (TIHW) study. Covariates including comorbidities, socioeconomic status, social support, health behaviors, body composition, and serum biomarkers were collected for analysis. Sarcopenia was defined using handgrip strength and gait speed cut-off values suggested by the Asian Working Group for Sarcopenia. Risk scores for sarcopenia were estimated by stepwise logistic regression. Among 1025 participants (mean age, 71.95 ± 6.89 years), 179 (17.5%) had sarcopenia. Seven items, including age, female sex, receiving social assistance pension, absence of exercise, being underweight, abnormal fasting glucose levels, and abnormal creatinine levels were selected for the Taiwan Risk Scores for Sarcopenia (TRSS) with a cutoff value of 76 (sensitivity, 71.8%; specificity, 71.1%) and area under the curve (AUC) of 0.757. Our results suggested that the TRSS model could be applied cost-effectively in the community for early detection of sarcopenia.
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Affiliation(s)
- Tzyy-Guey Tseng
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Chun-Kuan Lu
- Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Yu-Han Hsiao
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung 40343, Taiwan;
- Department of Public Health, Chung Shan Medical University, Taichung 40201, Taiwan
- College of Management, Chaoyang University of Technology, Taichung 41331, Taiwan
| | - Shu-Chuan Pan
- Department of Nursing, Pingtung Hospital, Ministry of Health and Welfare, Pingtung 90054, Taiwan;
| | - Chi-Jung Tai
- Department of Family Medicine, Pingtung Hospital, Ministry of Health and Welfare, Pingtung 90054, Taiwan
- Graduate Institute of Natural Products, College of Pharmacy, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: (C.-J.T.); (M.-C.L.); Tel.: +886-4-22294411 (M.-C.L.)
| | - Meng-Chih Lee
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung 40343, Taiwan;
- College of Management, Chaoyang University of Technology, Taichung 41331, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli 35053, Taiwan
- Correspondence: (C.-J.T.); (M.-C.L.); Tel.: +886-4-22294411 (M.-C.L.)
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Sobolev AP, Ciampa A, Ingallina C, Mannina L, Capitani D, Ernesti I, Maggi E, Businaro R, Del Ben M, Engel P, Giusti AM, Donini LM, Pinto A. Blueberry-Based Meals for Obese Patients with Metabolic Syndrome: A Multidisciplinary Metabolomic Pilot Study. Metabolites 2019; 9:metabo9070138. [PMID: 31295937 PMCID: PMC6680695 DOI: 10.3390/metabo9070138] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/05/2019] [Accepted: 07/07/2019] [Indexed: 12/23/2022] Open
Abstract
A pilot study was carried out on five obese/overweight patients suffering from metabolic syndrome, with the aim to evaluate postprandial effects of high fat/high glycemic load meals enriched by blueberries. Postprandial urine samples were analyzed by 1H-NMR spectroscopy after 2 and 4 h from ingestion to identify potential markers of blueberry intake. Significant decrease of methylamines, acetoacetate, acetone and succinate, known indicators of type 2 diabetes mellitus, were observed after the intake of meals enriched with blueberries. On the other hand, an accumulation of p-hydroxyphenyl-acetic acid and 3-(3’-hydroxyphenyl)-3-hydropropionic acid originating from gut microbial dehydrogenation of proanthocyanidins and procyanidins was detected. Real-time PCR-analysis of mRNAs obtained from mononuclear blood cells showed significant changes in cytokine gene expression levels after meals integrated with blueberries. In particular, the mRNAs expression of interleukin-6 (IL-6) and Transforming Growth Factor-β (TGF-β), pro and anti-inflammation cytokines, respectively, significantly decreased and increased after blueberry supplementation, indicating a positive impact of blueberry ingestion in the reduction of risk of inflammation. The combined analysis of the urine metabolome and clinical markers represents a promising approach in monitoring the metabolic impact of blueberries in persons with metabolic syndrome.
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Affiliation(s)
- Anatoly Petrovich Sobolev
- Laboratorio di Risonanza Magnetica "Annalaura Segre", Istituto per i Sistemi Biologici, CNR, via Salaria km 29.300, I-00015 Monterotondo, Italy
| | - Alessandra Ciampa
- Dipartimento di Chimica e Tecnologie del Farmaco, Sapienza Università di Roma, Piazzale Aldo Moro 5, I-00185 Roma, Italy
| | - Cinzia Ingallina
- Dipartimento di Chimica e Tecnologie del Farmaco, Sapienza Università di Roma, Piazzale Aldo Moro 5, I-00185 Roma, Italy.
| | - Luisa Mannina
- Laboratorio di Risonanza Magnetica "Annalaura Segre", Istituto per i Sistemi Biologici, CNR, via Salaria km 29.300, I-00015 Monterotondo, Italy.
- Dipartimento di Chimica e Tecnologie del Farmaco, Sapienza Università di Roma, Piazzale Aldo Moro 5, I-00185 Roma, Italy.
| | - Donatella Capitani
- Laboratorio di Risonanza Magnetica "Annalaura Segre", Istituto per i Sistemi Biologici, CNR, via Salaria km 29.300, I-00015 Monterotondo, Italy
| | - Ilaria Ernesti
- Sezione di Fisiopatologia Medica, Scienza dell'Alimentazione ed Endocrinologia - Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Piazzale Aldo Moro 5, I-00185 Roma, Italy
| | - Elisa Maggi
- Dipartimento di Scienze e Biotecnologie medico-chirurgiche, Sapienza Università di Roma, Corso della Repubblica 79, 04100 Latina, Italy
| | - Rita Businaro
- Dipartimento di Scienze e Biotecnologie medico-chirurgiche, Sapienza Università di Roma, Corso della Repubblica 79, 04100 Latina, Italy
| | - Maria Del Ben
- Dipartimento di Medicina Interna e Specialità Mediche, Policlinico Umberto 1 Sapienza Università di Roma, viale del Policlinico 151, I-00185, Roma, Italy
| | - Petra Engel
- Consiglio per la Ricerca in Agricoltura e l'Analisi dell'Economia Agraria (CREA), Ufficio Rapporti Istituzionali e Relazioni Internazionali, Via Po 14, 00198 Roma, Italy
| | - Anna Maria Giusti
- Sezione di Fisiopatologia Medica, Scienza dell'Alimentazione ed Endocrinologia - Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Piazzale Aldo Moro 5, I-00185 Roma, Italy
| | - Lorenzo M Donini
- Sezione di Fisiopatologia Medica, Scienza dell'Alimentazione ed Endocrinologia - Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Piazzale Aldo Moro 5, I-00185 Roma, Italy
| | - Alessandro Pinto
- Sezione di Fisiopatologia Medica, Scienza dell'Alimentazione ed Endocrinologia - Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Piazzale Aldo Moro 5, I-00185 Roma, Italy
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Khadra D, Itani L, Tannir H, Kreidieh D, El Masri D, El Ghoch M. Association between sarcopenic obesity and higher risk of type 2 diabetes in adults: A systematic review and meta-analysis. World J Diabetes 2019; 10:311-323. [PMID: 31139318 PMCID: PMC6522758 DOI: 10.4239/wjd.v10.i5.311] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/17/2019] [Accepted: 05/01/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The coexistence of sarcopenia and obesity is referred to as sarcopenic obesity (SO) and it has been hypothesized that the two components of SO may synergistically increase their negative effects. However, many uncertainties still surround this condition especially with regard to its potential negative effects on health outcomes.
AIM To conduct a systematic review to determine the prevalence of sarcopenia among adults with overweight and obesity and to investigate whether SO was associated with a higher risk of type 2 diabetes (T2D).
METHODS This study was conducted in adherence with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Literature searches, study selection, methodology development and quality appraisal were performed independently by two authors and the data were collated by means of meta-analysis and narrative synthesis.
RESULTS Of the 606 articles retrieved, 11 studies that comprised a total of 60118 adults with overweight and obesity of both genders met the inclusion criteria and were reviewed, revealing two main findings. First, the overall prevalence of sarcopenia is 43% in females and 42% in males who are with overweight and obesity. Secondly, the presence of SO increases the risk of T2D by 38% with respect to those without SO (OR = 1.38, 95%CI: 1.27-1.50).
CONCLUSION A high prevalence of sarcopenia has been found among adults with overweight and obesity regardless of their gender and this condition seems to be associated with a higher risk of T2D. Clinician should be aware of this scenario in their clinical practice for the better management of both obesity and T2D.
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Affiliation(s)
- Dima Khadra
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut 11072809, Lebanon
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut 11072809, Lebanon
| | - Hana Tannir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut 11072809, Lebanon
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut 11072809, Lebanon
| | - Dana El Masri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut 11072809, Lebanon
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut 11072809, Lebanon
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Poggiogalle E, Lubrano C, Gnessi L, Mariani S, Di Martino M, Catalano C, Lenzi A, Donini LM. The decline in muscle strength and muscle quality in relation to metabolic derangements in adult women with obesity. Clin Nutr 2019; 38:2430-2435. [PMID: 30792144 DOI: 10.1016/j.clnu.2019.01.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 01/15/2019] [Accepted: 01/28/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND & AIMS The metabolic and functional characteristics related to sarcopenic obesity have not been thoroughly explored in the earlier stages of the aging process. The aim of the present study was to examine the phenotype of sarcopenic obesity, in terms of lean body mass, muscle strength and quality, in adult women with and without the Metabolic Syndrome (MetS), and its relationship with the features of myosteatosis. METHODS Study participants were enrolled at the Sapienza University, Rome, Italy. Body composition was assessed by DXA. The Handgrip strength test (HGST) was performed. HGST was normalized to arm lean mass to indicate muscle quality; intermuscular adipose tissue (IMAT) and intramyocellular lipid content (IMCL) were measured by magnetic resonance imaging and spectroscopy, as indicators of myosteatosis. Different indices of sarcopenia were calculated, based on appendicular lean mass (ALM, kg) divided by height squared, or weight. The NCEP-ATPIII criteria were used to diagnose the MetS. HOMA-IR was calculated. The physical activity level (PAL) was assessed through the IPAQ questionnaire. RESULTS 54 women (age: 48 ± 14 years, BMI: 37.9 ± 5.4 kg/m2) were included. 54% had the MetS (metabolically unhealthy, MUO). HGST/arm lean mass was lower in MUO women than women without the MetS (6.3 ± 1.8 vs. 7.8 ± 1.6, p = 0.03). No differences emerged in terms of absolute ALM (kg) or other indices of sarcopenia (ALM/h2 or ALM/weight) between metabolically healthy (MHO) vs. MUO women (p > 0.05). Muscle quality was negatively associated with HOMA-IR (p = 0.02), after adjustment for age, body fat, hs-CRP levels, and PAL. IMAT, but not IMCL, was significantly higher in obese women with the MetS compared to women without the MetS (p > 0.05). No association emerged between HGST/arm lean mass and IMAT or IMCL when HOMA-IR was included in the models. CONCLUSION Insulin resistance, and not sarcopenia or myosteatosis per se, was associated with muscle weakness, resulting in the phenotype of "dynapenic obesity" in middle-aged women with the metabolic syndrome.
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Affiliation(s)
- Eleonora Poggiogalle
- Department of Experimental Medicine-Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University, Rome, Italy.
| | - Carla Lubrano
- Department of Experimental Medicine-Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University, Rome, Italy
| | - Lucio Gnessi
- Department of Experimental Medicine-Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University, Rome, Italy
| | - Stefania Mariani
- Department of Experimental Medicine-Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University, Rome, Italy
| | - Michele Di Martino
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University, Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine-Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University, Rome, Italy
| | - Lorenzo Maria Donini
- Department of Experimental Medicine-Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University, Rome, Italy
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Jang BY, Bu SY. A Vegetable and Fish Dietary Pattern Is Positively Associated with Skeletal Muscle Mass in Korean Men. Clin Nutr Res 2019; 8:1-16. [PMID: 30746343 PMCID: PMC6355951 DOI: 10.7762/cnr.2019.8.1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 01/22/2019] [Accepted: 01/23/2019] [Indexed: 12/22/2022] Open
Abstract
Isolating the effects of a single nutrient or food in relation to health outcomes including increased skeletal muscle mass is a challenging task because dietary constituents are highly correlated and synergistic. Hence, diet pattern analysis may be used to investigate the role of certain diets in health outcomes. The present study investigated the dietary patterns and their relationship to skeletal muscle mass in Korean adults. Data were extracted from the 2008–2011 Korea National Health and Nutrition Examination Surveys. To explore the dietary patterns of the study subjects, factor analysis was performed using data obtained from a 24-hour recall. The skeletal muscle index according to dietary pattern scores was then investigated to estimate the changes in skeletal muscle mass. Three patterns were initially identified from the factor analysis. Of these vegetables and fish (VF) pattern was the primary factor with high reliability and was a common factor in sex-separated analyses. The VF pattern scores were positively associated with increased skeletal muscle mass in both men and women. Further analysis according to quartile levels of VF pattern scores showed a positive association between skeletal muscle mass and VF pattern in men but not in women. These results suggest that dietary patterns focused on vegetables and seafoods may contribute to increased skeletal muscle mass in Korean men but that sex difference should be considered in nutrition care for skeletal muscle health.
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Affiliation(s)
- Bo Young Jang
- Department of Food and Nutrition, College of Engineering, Daegu University, Gyeongsan 38453, Korea
| | - So Young Bu
- Department of Food and Nutrition, College of Engineering, Daegu University, Gyeongsan 38453, Korea
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43
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Association between Sarcopenic Obesity, Type 2 Diabetes, and Hypertension in Overweight and Obese Treatment-Seeking Adult Women. J Cardiovasc Dev Dis 2018; 5:jcdd5040051. [PMID: 30347794 PMCID: PMC6306700 DOI: 10.3390/jcdd5040051] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 12/14/2022] Open
Abstract
The last decade has seen a new condition that describes the coexistence of obesity and sarcopenia, termed sarcopenic obesity (SO). We aimed to assess the prevalence of SO in overweight and obese treatment-seeking adult women and the association with type 2 diabetes, hypertension, and dyslipidemia. A body composition assessment was conducted with an InBody bioimpedance analyser in 154 overweight and obese women referred to the Outpatient Clinic in the Department of Nutrition and Dietetics at Beirut Arab University (BAU) in Lebanon, and 30 normal-weight participants of similar age. The overweight and obese patients were then categorized as being with or without sarcopenia. Thirty-one out of the 154 overweight or obese participants met the criteria for SO and displayed a significantly higher prevalence of type 2 diabetes and hypertension than those without SO. Logistic regression analysis showed that SO increases the odds of having type 2 diabetes and hypertension by nearly 550% (odds ratio = 5.42, 95% confidence interval = 1.37⁻21.40, p < 0.05) after adjusting for central fat, eating habits, level of physical activity, and smoking. SO affects nearly 20% of treatment-seeking overweight and obese adult women. Moreover, SO seems to be strongly associated with type 2 diabetes and hypertension.
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44
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The Association between Nonalcoholic Fatty Liver Disease and CT-Measured Skeletal Muscle Mass. J Clin Med 2018; 7:jcm7100310. [PMID: 30274215 PMCID: PMC6211085 DOI: 10.3390/jcm7100310] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/14/2018] [Accepted: 09/25/2018] [Indexed: 02/07/2023] Open
Abstract
A relationship between nonalcoholic fatty liver disease (NAFLD) and sarcopenia has been suggested. The aim of this study was to evaluate the association between NAFLD and skeletal muscle mass measured by computed tomography (CT). The clinical records of individuals visiting our center for a routine health check-up who underwent abdominal ultrasonography and abdominal CT scanning were retrospectively reviewed. Sarcopenia was diagnosed according to body mass index (BMI)-adjusted skeletal muscle mass, which was measured by CT (CT-measured skeletal muscle index (SMICT)). Of the 1828 subjects (1121 males; mean age 54.9 ± 9.5 years), 487 (26.6%) were obese (BMI ≥ 25 kg/m2), and 454 (24.8%) had low muscle mass. Sarcopenic subjects had a significantly higher prevalence of NAFLD than nonsarcopenic subjects, regardless of obesity (35.9% vs. 26.8%, p = 0.004 in the nonobese group; 76.6% vs. 63.0%, p = 0.003 in the obese group). Sarcopenia was significantly associated with the risk of NAFLD (adjusted odds ratio (OR) (95% confidence interval (CI)), 1.51 (1.15–1.99)), and the risk of NAFLD increased with increasing severity of sarcopenia (adjusted OR (95% CI), 1.45 (1.09–1.92) vs. 2.51 (1.16–5.56), mild vs. severe sarcopenia, respectively). When the risk of NAFLD was analyzed according to the SMICT quartiles, the adjusted OR and 95% CI for the lowest muscle mass quartile compared to the highest were 1.78 (1.17–2.72) in males and 2.39 (1.13–5.37) in females. Low skeletal muscle mass, which was precisely measured by CT, is independently associated with NAFLD, suggesting that sarcopenia is a risk factor for NAFLD.
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45
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Abstract
Sarcopenic obesity, a chronic condition, is today a major public health problem with increasing prevalence worldwide, which is due to progressively aging populations, the increasing prevalence of obesity, and the changes in lifestyle during the last several decades. Patients usually present to healthcare facilities for obesity and related comorbidities (type 2 diabetes mellitus, non-alcoholic fatty liver disease, dyslipidemia, hypertension, and cardiovascular disease) or for non-specific symptoms related to sarcopenia per se (e.g., fatigue, weakness, and frailty). Because of the non-specificity of the symptoms, sarcopenic obesity remains largely unsuspected and undiagnosed. The pathogenesis of sarcopenic obesity is multifactorial. There is interplay between aging, sedentary lifestyle, and unhealthy dietary habits, and insulin resistance, inflammation, and oxidative stress, resulting in a quantitative and qualitative decline in muscle mass and an increase in fat mass. Myokines, including myostatin and irisin, and adipokines play a prominent role in the pathogenesis of sarcopenic obesity. It has been suggested that a number of disorders affecting metabolism, physical capacity, and quality of life may be attributed to sarcopenic obesity, although it is not as yet established whether sarcopenia and obesity act synergistically. There is to date no approved pharmacological treatment for sarcopenic obesity. The cornerstones of its management are weight loss and adequate protein intake combined with exercise, the latter in order to reduce the loss of muscle mass observed during weight loss following diet unpaired with exercise. A consensus on the definition of sarcopenic obesity is considered essential to facilitate the performance of mechanistic studies and clinical trials aimed at deepening our knowledge, thus enabling improved management of affected individuals in the near future.
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Affiliation(s)
- Stergios A Polyzos
- First Department of Pharmacology, Medical School, Aristotle University of Thessaloniki, 13 Simou Lianidi, 551 34, Thessaloniki, Greece.
| | - Andrew N Margioris
- Laboratory of Clinical Chemistry and Biochemistry, School of Medicine, University of Crete, Heraklion, Greece
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Effects of Adherence to a Higher Protein Diet on Weight Loss, Markers of Health, and Functional Capacity in Older Women Participating in a Resistance-Based Exercise Program. Nutrients 2018; 10:nu10081070. [PMID: 30103509 PMCID: PMC6115985 DOI: 10.3390/nu10081070] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 12/19/2022] Open
Abstract
Resistance training and maintenance of a higher protein diet have been recommended to help older individuals maintain muscle mass. This study examined whether adherence to a higher protein diet while participating in a resistance-based exercise program promoted more favorable changes in body composition, markers of health, and/or functional capacity in older females in comparison to following a traditional higher carbohydrate diet or exercise training alone with no diet intervention. In total, 54 overweight and obese females (65.9 ± 4.7 years; 78.7 ± 11 kg, 30.5 ± 4.1 kg/m2, 43.5 ± 3.6% fat) were randomly assigned to an exercise-only group (E), an exercise plus hypo-energetic higher carbohydrate (HC) diet, or a higher protein diet (HP) diet. Participants followed their respective diet plans and performed a supervised 30-min circuit-style resistance exercise program 3 d/wk. Participants were tested at 0, 10, and 14 weeks. Data were analyzed using univariate, multivariate, and repeated measures general linear model (GLM) statistics as well as one-way analysis of variance (ANOVA) of changes from baseline with [95% confidence intervals]. Results revealed that after 14 weeks, participants in the HP group experienced significantly greater reductions in weight (E −1.3 ± 2.3, [−2.4, −0.2]; HC −3.0 ± 3.1 [−4.5, −1.5]; HP −4.8 ± 3.2, [−6.4, −3.1]%, p = 0.003), fat mass (E −2.7 ± 3.8, [−4.6, −0.9]; HC −5.9 ± 4.2 [−8.0, −3.9]; HP −10.2 ± 5.8 [−13.2, –7.2%], p < 0.001), and body fat percentage (E −2.0 ± 3.5 [−3.7, −0.3]; HC −4.3 ± 3.2 [−5.9, −2.8]; HP −6.3 ± 3.5 [−8.1, −4.5] %, p = 0.002) with no significant reductions in fat-free mass or resting energy expenditure over time or among groups. Significant differences were observed in leptin (E −1.8 ± 34 [−18, 14]; HC 43.8 ± 55 [CI 16, 71]; HP −26.5 ± 70 [−63, −9.6] ng/mL, p = 0.001) and adiponectin (E 43.1 ± 76.2 [6.3, 79.8]; HC −27.9 ± 33.4 [−44.5, −11.3]; HP 52.3 ± 79 [11.9, 92.8] µg/mL, p = 0.001). All groups experienced significant improvements in muscular strength, muscular endurance, aerobic capacity, markers of balance and functional capacity, and several markers of health. These findings indicate that a higher protein diet while participating in a resistance-based exercise program promoted more favorable changes in body composition compared to a higher carbohydrate diet in older females.
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47
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Jang BY, Bu SY. Total energy intake according to the level of skeletal muscle mass in Korean adults aged 30 years and older: an analysis of the Korean National Health and Nutrition Examination Surveys (KNHANES) 2008-2011. Nutr Res Pract 2018; 12:222-232. [PMID: 29854328 PMCID: PMC5974068 DOI: 10.4162/nrp.2018.12.3.222] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/26/2018] [Accepted: 04/12/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND/OBJECTIVES Since gain or loss of skeletal muscle mass is a gradual event and occurs due to a combination of lifestyle factors, assessment of dietary factors related to skeletal muscle is complicated. The aim of this study was to investigate the changes in total energy intake according to the level of skeletal muscle mass. SUBJECTS/METHODS A total of 8,165 subjects ≥ 30 years of age from the Korean National Health and Nutrition Examination Surveys (KNHANES) 2008-2011 were included in the analysis, and multivariate-adjusted regression analyses were performed to analyze the association of the quartiles of sarcopenia index (SI) with energy intake of the study population after adjusting for age and metabolic parameters. RESULTS The increase in SI quartile was in proportion to the gradual decrease in systemic lipids and the anthropometric measurement of fat accumulation (P < 0.001). Subjects in higher SI quartiles tended to consume more total energy and energy-producing nutrients than those in lower quartiles (P < 0.001). After age, body weight, alcohol consumption, and metabolic parameters were adjusted in the analysis, total energy intake gradually increased according to the increase in SI quartile, and the association between total energy intake and SI was more pronounced in men. However, the risk (odd ratio) of having a low SI was not affected by any single macronutrient intake. CONCLUSIONS In this study, total energy intake was positively associated with SI and relative skeletal mass in both men and women. However, no significant association or a weak association was observed between any single macronutrient intake and skeletal muscle mass. The data indicated that acquiring more energy intake within the normal range of energy consumption may help to maintain skeletal muscle mass.
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Affiliation(s)
- Bo Young Jang
- Department of Food and Nutrition, Daegu University, 201 Daegudae-ro, Gyeongsan-si, Gyeongbuk 38453, Korea
| | - So Young Bu
- Department of Food and Nutrition, Daegu University, 201 Daegudae-ro, Gyeongsan-si, Gyeongbuk 38453, Korea
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48
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Johnson Stoklossa CA, Ghosh SS, Forhan M, Sharma AM, Terada T, Siervo M, Baracos VE, Padwal RS, Hung PA, Sawyer MB, Maia YLM, Prado CM. Poor Physical Function as a Marker of Sarcopenia in Adults with Class II/III Obesity. Curr Dev Nutr 2018; 2:nzx008. [PMID: 30377678 PMCID: PMC6201683 DOI: 10.3945/cdn.117.001743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/12/2017] [Accepted: 12/18/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Adults with class II/III obesity [body mass index (in kg/m2) ≥35] may present with a phenotype characterized by low lean mass and excess fat mass, a condition known as sarcopenic obesity (SO). Little is known about the prevalence and relevance of SO in these individuals, primarily due to a lack of relevant diagnostic criteria. OBJECTIVE Here, we explored the definition of SO based on physical function as an outcome of interest in adults with class II/III obesity and applied this definition to compare clinical characteristics between SO and non-SO patients. METHODS In this cross-sectional analysis, patients' demographic, anthropometric, and biochemical characteristics, as well as comorbidities and physical activity levels, were collected at an obesity specialty clinic prior to any treatment. Body composition was assessed by dual-energy X-ray absorptiometry. Physical function was assessed by self-reported difficulties with activities of daily living (ADLs) from an 11-item questionnaire. Five SO definitions were tested against reported difficulty with ADLs with the use of receiver operating characteristic (ROC) analysis. RESULTS A total of 120 subjects (86% women) aged 46 ± 11 y were included. Based on ROC analysis, SO was best defined by an appendicular skeletal mass (ASM)/weight x 100 (%) <19.35% for women and <24.33% for men, resulting in a prevalence of 25% (n = 30, women 22.3%, men 41.2%). SO was significantly associated with older age, higher waist circumference, higher triglycerides, greater use of antihypertensive medications, and lower physical activity. CONCLUSIONS In this sample of adults with class II/III obesity, difficulties with ADLs were best associated with measures of ASM in relation to total body weight. Patients identified with SO using this criterion presented with poorer clinical outcomes such as factors of elevated cardiometabolic risk.
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Affiliation(s)
| | - Sunita S Ghosh
- Departments of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Mary Forhan
- Departments of Oncology Occupational Therapy, University of Alberta, Edmonton, AB, Canada
| | - Arya M Sharma
- Departments of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Tasuku Terada
- Departments of Oncology Occupational Therapy, University of Alberta, Edmonton, AB, Canada
| | - Mario Siervo
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Vickie E Baracos
- Departments of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Raj S Padwal
- Departments of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Pam A Hung
- Primary Health Care, Alberta Health Services, Edmonton General Hospital, Edmonton, AB, Canada
| | - Michael B Sawyer
- Departments of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Yara LM Maia
- Curso de Farmácia, Universidade Paulista Campus Flamboyant and Faculdade Estácio de Sá, Goiânia, Goiás, Brazil
| | - Carla M Prado
- Departments of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
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Association of muscle mass and fat mass with insulin resistance and the prevalence of metabolic syndrome in Korean adults: a cross-sectional study. Sci Rep 2018; 8:2703. [PMID: 29426839 PMCID: PMC5807388 DOI: 10.1038/s41598-018-21168-5] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 01/25/2018] [Indexed: 12/20/2022] Open
Abstract
Relationship of muscle mass and fat mass with insulin resistance and metabolic syndrome remains uncertain, especially among Asian population. We performed a cross-sectional study with 14,807 adult participants aged between 18 and 65 in the fourth and fifth Korea National Health and Nutrition Examination Survey with Dual Energy X-ray Absorptiometry (DEXA) data to investigate whether muscle mass and fat mass are associated with insulin resistance and metabolic syndrome. DEXA records were used to categorize the participants into four categories (low muscle/low fat, low muscle/high fat, high muscle/ low fat, and high muscle/high fat). Least square means and incidence rate ratios (IRR) were used to assess the associations of muscle mass and fat mass with insulin resistance and metabolic syndrome. After adjustment for potential confounders, high muscle/low fat was associated with significantly lower insulin resistance (P < 0.001) compared to low muscle/low fat. Low muscle/high fat (IRR: 1.90; 95% confidence interval [CI]:1.44-2.50, P < 0.001) and high muscle/high fat (IRR: 2.30; 95% CI:1.76-3.00, P < 0.001) were significantly associated with the prevalence of metabolic syndrome. Our study suggests that protective association of muscle mass with metabolic syndrome is attenuated by high fat mass in Korean adults.
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50
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Song M, Xia L, Liu Q, Sun M, Wang F, Yang C. Sarcopenia in Liver Disease: Current Evidence and Issues to Be sResolved. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1088:413-433. [PMID: 30390263 DOI: 10.1007/978-981-13-1435-3_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Sarcopenia is a common clinical symptom in aging and patients with wasting diseases, characterized by a decreased skeletal muscle mass. As a consequence of lifestyle change, the nonalcoholic fatty liver disease (NAFLD) presents a rising trend. In the past three decades, increasing evidence has proved that sarcopenia is related to NAFLD. In this chapter, we will summarize the emerging evidence of the predictive role of sarcopenia in NAFLD and review the diagnosis value, feasible mechanism, and therapy strategies of sarcopenia in NAFLD. Sarcopenia is a potential risk factor for NAFLD, and targeting sarcopenia can benefit NAFLD to some extent.
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Affiliation(s)
- Meiyi Song
- Division of Gastroenterology and Hepatology, Digestive Disease Institute, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lu Xia
- Division of Gastroenterology and Hepatology, Digestive Disease Institute, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qi Liu
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Mengxue Sun
- Division of Gastroenterology and Hepatology, Digestive Disease Institute, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Fei Wang
- Division of Gastroenterology and Hepatology, Digestive Disease Institute, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Changqing Yang
- Division of Gastroenterology and Hepatology, Digestive Disease Institute, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
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